Individual provider Active NPI

Kyle T Christopher

  • Physician Assistant
  • Greenville, MS
National Provider Identifier
1770021982
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00314 Issued in MS
Practice address
1400 E Union St
Greenville, MS 38703-3246
Phone
(662) 378-3783
NPI assigned
Feb 8, 2017
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00314 MS Primary

Addresses

Primary practice location

1400 E Union St
Greenville, MS 38703-3246

Mailing address

PO Box 4739
Greenville, MS 38704-4739
Phone (662) 725-2737

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
I20170227002445 MS Practitioner - Physician Assistant 9335423946 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Medical GroupGroup PAC ID 6608775531, 48 clinicians
Delta Heart and Vascular Center, P.a.Group PAC ID 1355390063, 4 clinicians
Grenada Emergency Group, LLCGroup PAC ID 2163854225, 37 clinicians

Practice addresses (Care Compare)

1400 E Union St
Greenville, MS 38703-3246
Phone (662) 378-3783

1513 E Union St
Greenville, MS 38703-3249
Phone (662) 846-6034

1693 Fairgrounds Rd
Greenville, MS 38703-7810
Phone (662) 378-3783

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grenada Emergency Group, LLC Physician Assistant CurrentSince Feb 8, 2026 Accepting new patients
Delta Physician Practices Past Accepting new patients

Locations

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

Organizations & group practices 4

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 6

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": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1770021982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4739",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387044739",
            "telephone_number": "662-725-2737",
            "fax_number": "662-725-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E UNION ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387033246",
            "telephone_number": "662-378-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHER",
        "first_name": "KYLE",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-08",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.