Theresa Danyell McKissick, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

905796 Issued in MS

Practice address

365 Wire Rd W
Perkinston, MS 39573-5723

Phone

(601) 528-1496

NPI assigned

Feb 16, 2023

Last updated

Feb 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, AL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RH Hospitalist Medicine of Highland Community LLCGroup PAC ID 8022451038, 15 clinicians

Relias Clinical Decision Specialists of Hattiesburg LLCGroup PAC ID 3173998358, 14 clinicians

Relias Emergency Medicine Specialists of Hattiesburg LLCGroup PAC ID 9032549142, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
• Highland Community Hospital Hospital, Picayune, MS, CCN 250117

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Relias Clinical Decision Specialists of Hattiesburg, LLC

  • Emergency Medicine Physician
  • Hattiesburg, MS
  • NPI 1336867415
  Medicare reassignment Care Compare group NPD
• Relias Emergency Medicine Specialists of Hattiesburg LLC

  • Emergency Medicine Physician
  • Hattiesburg, MS
  • NPI 1609409440
  Medicare reassignment Care Compare group NPD
• RH Hospitalist Medicine of Highland Community LLC

  • Hospitalist Physician
  • Picayune, MS
  • NPI 1841068756
  Medicare reassignment Care Compare group NPD
• RH Emergency Medicine of Highland Community LLC

  • Emergency Medicine Physician
  • Picayune, MS
  • NPI 1033987946
  Medicare reassignment NPD
• RH Hospitalist Medicine of Marion General LLC

  • Hospitalist Physician
  • Columbia, MS
  • NPI 1801660170
  Medicare reassignment NPD
• Relias Emergency Medicine Specialists of Fayette, LLC

  • Emergency Medicine Physician
  • Fayette, AL
  • NPI 1093201543
  Medicare reassignment NPD

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

• Forrest County General Hospital

  dba Highland Community Hospital

  • General Acute Care Hospital
  • Picayune, MS
  • NPI 1053350462
  Care Compare affiliation
• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1962100347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 WIRE RD W",
            "city": "PERKINSTON",
            "state": "MS",
            "postal_code": "395735723",
            "telephone_number": "601-528-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 WIRE RD W",
            "city": "PERKINSTON",
            "state": "MS",
            "postal_code": "395735723",
            "telephone_number": "601-528-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "THERESA",
        "middle_name": "DANYELL",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva's Place, LLC
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• Ladner Chiropractic PC
• Brenna R Ladner, RN
• Jordan Marie Peterson
• Dana Sharp
• Surgicalfirst, LLC
• Patrysha Ann Switzer, REGISTERED NURSE
• Kendall Turner

• Family Nurse Practitioner in Perkinston, MS
• Providers in Perkinston, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.