Katrina Baxter, NP
Individual provider Active NPI Nurse Practitioner · Gulfport, MS
NPI 1972181006 · NPPES record last updated Aug 4, 2021
Key facts
- NPI
- 1972181006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 904601 (MS)
- Practice address
- 1391 Broad Ave
Gulfport, MS 39501-2419 - Phone
- (228) 863-8868
- Fax
- (228) 863-8132
- NPI assigned
- Mar 30, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 60
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Mississippi PLLC
Minor Med Care, LLC
Practice addresses (Care Compare)
1130 Frontage Dr W
Wiggins, MS 39577-8165
Phone (601) 716-8012
120 W Main St
Raymond, MS 39154-1223
Phone (601) 857-2341
Hospital & facility affiliations
- Memorial Hospital at Gulfport
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210821000282 | MS | Practitioner - Nurse Practitioner | 0345645842 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 904601 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Fast Pace Mississippi, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Upperline Healthcare, PC | Family Medicine | Current |
Accepting new patients |
| Monogram Health Professional Services PC | Family Medicine | Current |
Accepting new patients |
| Fast Pace Mississippi, PLLC | Current |
Accepting new patients | |
| Monogram Health Professional Services PC | Family Medicine | Current |
Accepting new patients |
Locations
700 Sunset Dr
Grenada, MS 38901
Phone (662) 307-2884
7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661
603 Craft St
Holly Springs, MS 38635
Phone (662) 333-8070
1000 Highland Colony Pkwy
Ste 5203
Ridgeland, MS 39157
Phone (601) 427-4734
517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206
1130 Frontage Dr W
Wiggins, MS 39577
Phone (601) 716-8012
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 904601 | MS | Yes |
Addresses
Primary practice location
1391 Broad Ave
Gulfport, MS 39501-2419
Mailing address
650 S Griffin St
Dallas, TX 75202-5005
Other providers in Gulfport, MS
- Kylee Barter
- Amy Bass-Longo
- Rebecca Branton Bass
- Korilyn Celest Baudoin
- Debra B Baxter
- Bay Breeze Dental Group
- Lenora Jean Bayes
- Sara Lynn Baylor
- Tania Georgieva Bayne
- Beach Pharmacy Inc
All providers in Gulfport, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.