Individual provider Active NPI

Kristin Blair Patterson, FNP-C

  • Family Nurse Practitioner
  • Amory, MS
National Provider Identifier
1902454317
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903520 Issued in MS
Practice address
1215 Earl Frye Blvd
Amory, MS 38821-5509
Phone
(731) 394-1145
Fax
(844) 374-0233
NPI assigned
Aug 28, 2019
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 903520 MS Primary

Addresses

Primary practice location

1215 Earl Frye Blvd
Amory, MS 38821-5509

Mailing address

30029 Bishop Rd
Nettleton, MS 38858-9361
Phone (662) 610-5336

Other practice location 1

65 S Thomas St
Tupelo, MS 38801-4352
Phone (662) 205-4475

Other practice location 2

2464 Main St
Plantersville, MS 38862-5002
Phone (662) 842-4877

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
I20191125001615 MS Practitioner - Nurse Practitioner 5991138398 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Health Corp of Houston, Inc.Group PAC ID 0042102352, 10 clinicians
Progressive Health of Houston LLCGroup PAC ID 0143662429, shared by 4 NPIs, 17 clinicians

Practice addresses (Care Compare)

1002 E Madison St
Houston, MS 38851-2428

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903520MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Strategic Solutions-Panola Medical Center LLC CurrentSince Mar 1, 2021 Accepting new patients
East Main Family Medical Clinic LLC Current Accepting new patients
Strategic Solutions-Panola Medical Center LLC CurrentSince Mar 1, 2021 Accepting new patients
Strategic Solutions-Panola Medical Center LLC Current Accepting new patients
Ultra Health LLC CurrentSince Feb 22, 2021 Accepting new patients
Plantersville Clinic, Inc Family CurrentSince Aug 28, 2019 Accepting new patients
Urgent and Family Care of Houston Past Accepting new patients

Locations

1215 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-9344

255 Medical Center Dr
Batesville, MS 38606
Phone (662) 563-2163

303 Medical Center Dr
Batesville, MS 38606
Phone (662) 563-0155

156 E Walnut Ave
Eupora, MS 39744
Phone (662) 258-8293

1220 E Northside Dr
Ste 170
Jackson, MS 39211
Phone (601) 394-8209

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1902454317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30029 BISHOP RD",
            "city": "NETTLETON",
            "state": "MS",
            "postal_code": "388589361",
            "telephone_number": "662-610-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 EARL FRYE BLVD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388215509",
            "telephone_number": "731-394-1145",
            "fax_number": "844-374-0233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 S Thomas St",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "388014352",
            "country_code": "US",
            "telephone_number": "662-205-4475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2464 Main St",
            "address_purpose": "LOCATION",
            "city": "Plantersville",
            "state": "MS",
            "postal_code": "388625002",
            "country_code": "US",
            "telephone_number": "662-842-4877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "KRISTIN",
        "middle_name": "BLAIR",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amory, MS

Sources for this page

Verify at the official NPI Registry.