Individual provider Active NPI

Kathryn Claiborne Alexander

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1962716894
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R877658 Issued in MS
Practice address
3502 W Northside Dr
Jackson, MS 39213-4454
Phone
(601) 364-5142
Fax
(601) 364-5159
NPI assigned
Aug 3, 2010
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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 R877658 MS Primary

Addresses

Primary practice location

3502 W Northside Dr
Jackson, MS 39213-4454

Mailing address

PO Box 24116
Jackson, MS 39225-4116
Phone (601) 825-7280

Other practice location 1

325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923
Phone (888) 731-8994

Other identifiers 1

IdentifierTypeStateIssuer
04828561MedicaidMS

Other names 1

  • Kathryn Lashonda Claiborne Former name

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
I20111011000420 MS Practitioner - Nurse Practitioner 0345412672 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Care Clinic, Inc. Current Accepting new patients
Community Care Health Network LLC CurrentSince Aug 1, 2021 Accepting new patients
Family Health Care Clinic, Inc. CurrentSince Dec 22, 2014 Accepting new patients
Central Mississippi Civic Improvement Association, Inc. Past Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

290 Highway 51 N
Brookhaven, MS 39601
Phone (601) 823-1710

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

4635 Highway 80 E
Pearl, MS 39208
Phone (601) 502-3009

910 Second St
Prentiss, MS 39474
Phone (601) 792-2078

Organizations & group practices 5

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1962716894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24116",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392254116",
            "telephone_number": "601-825-7280",
            "fax_number": "601-825-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-364-5142",
            "fax_number": "601-364-5159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N Saint Paul St Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752013923",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "KATHRYN",
        "middle_name": "CLAIBORNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R877658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04828561",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "CLAIBORNE",
            "middle_name": "LASHONDA",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.