Individual provider Active NPI

Kathryn Amanda Arnold, NP-C

  • Adult Health Nurse Practitioner
  • McComb, MS
National Provider Identifier
1730587767
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R870540 Issued in MS
Practice address
215 Marion Ave
McComb, MS 39648-2705
Phone
(601) 249-5500
Fax
(601) 249-1714
NPI assigned
Dec 8, 2014
Last updated
May 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R870540 MS Primary

Addresses

Primary practice location

215 Marion Ave
McComb, MS 39648-2705

Mailing address

PO Box 490
McComb, MS 39649-0490
Phone (601) 250-4366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915002870 MS Practitioner - Nurse Practitioner 2264749811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interventional Spine and Sports InstituteGroup PAC ID 3678617958, 3 clinicians

Practice addresses (Care Compare)

216 S 13TH Ave
Laurel, MS 39440-4226
Phone (601) 292-6299

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.45 of 100Reported as group
Quality
57.87
Promoting interoperability
84
Improvement activities
40
Cost
65.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R870540MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Spine & Sports Institute CurrentSince Feb 5, 2024 Accepting new patients

Locations

92 Hal Crocker Rd
Ellisville, MS 39437
Phone (601) 261-0105

6555 U S Highway 98
Ste D
Hattiesburg, MS 39402

216 S 13th Ave
Laurel, MS 39440
Phone (601) 292-6299

300 Rawls Dr
Ste 1500
McComb, MS 39648
Phone (601) 249-2142

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13202/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kathryn.arnold.1@13202.direct.athenahealth.com

Organizations & group practices 1

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

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": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1730587767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-250-4366",
            "fax_number": "601-250-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482705",
            "telephone_number": "601-249-5500",
            "fax_number": "601-249-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "KATHRYN",
        "middle_name": "AMANDA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R870540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.