Individual provider Active NPI

Kalyn Elizabeth Thompson, DNP

  • Certified Registered Nurse Anesthetist
  • Meridian, MS
National Provider Identifier
1669996823
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
23176 Issued in TN
Practice address
1800 12TH St
Meridian, MS 39301-4158
Phone
(601) 484-6700
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 211439 TN
Certified Registered Nurse Anesthetist 367500000X 23176 TN Primary

Addresses

Primary practice location

1800 12TH St
Meridian, MS 39301-4158

Mailing address

1900 Exeter Rd Ste 210
Germantown, TN 38138-2954
Phone (901) 818-2160

Other practice location 1

4700 26th Ave
Meridian, MS 39305-4706
Phone (601) 485-6325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210504000489 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850667940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meridian Anesthesiology Group, IncGroup PAC ID 1759345192, 23 clinicians
Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians

Practice addresses (Care Compare)

1200 16TH Ave
Meridian, MS 39301-4209
Phone (601) 485-6325

1314 19TH Ave
Meridian, MS 39301-4116
Phone (601) 484-6700

2401 16TH St
Meridian, MS 39301-3950
Phone (601) 482-4181

Hospital & facility affiliations

  • Ochsner Rush Hospital Hospital, Meridian, MS, CCN 250069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
211439TNMDRegistered Nurse
23176TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation, Inc. CurrentSince May 1, 2021 Accepting new patients
Meridian Anesthesiology Group, Inc Nurse Anesthetist, Certified Registered CurrentSince May 1, 2021 Accepting new patients
Medical Foundation, Inc. CurrentSince May 1, 2021 Accepting new patients

Locations

1800 12th St
Meridian, MS 39301
Phone (601) 483-0011

2401 16th St
Meridian, MS 39301
Phone (601) 482-4181

4700 26th Ave
Meridian, MS 39305
Phone (601) 453-3249

1200 16th Ave
Meridian, MS 39301
Phone (601) 703-1901

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1669996823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 EXETER RD STE 210",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382954",
            "telephone_number": "901-818-2160",
            "fax_number": "901-682-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 12TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014158",
            "telephone_number": "601-484-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 26th Ave",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393054706",
            "country_code": "US",
            "telephone_number": "601-485-6325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KALYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "211439",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "23176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.