NPIMap

Individual provider Active NPI

Katelyn Rebecca Moffett, FNP-C

  • Family Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1972875995
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R882198 Issued in MS
Practice address
1102 Constitution Ave
Meridian, MS 39301-4001
Phone
(601) 683-3117
Fax
(601) 683-2505
NPI assigned
Feb 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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 R882198 MS Primary

Addresses

Primary practice location

1102 Constitution Ave
Meridian, MS 39301-4001

Mailing address

1102 Constitution Ave
Meridian, MS 39301-4001
Phone (601) 703-5600

Other identifiers 1

IdentifierTypeStateIssuer
04584751MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120606000274 MS Practitioner - Nurse Practitioner 6002070968 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neshoba County General HospitalGroup PAC ID 6204738289, 30 clinicians
The Columbus Orthopaedic Clinic, P.a.Group PAC ID 5890751945, 52 clinicians
Pain Management Ctr MeridianGroup PAC ID 8224080247, 7 clinicians

Practice addresses (Care Compare)

1001 Holland Ave
Philadelphia, MS 39350-2161
Phone (601) 663-1200

1102 Constitution Ave
Meridian, MS 39301-4001
Phone (601) 703-5600

5002 Hwy 39 N
BLDG C
Meridian, MS 39301-1078
Phone (601) 385-9111

640 Leigh Dr
Columbus, MS 39705-3014
Phone (662) 328-1012

670 Leigh Dr
Columbus, MS 39705-3014
Phone (662) 328-1012

Hospital & facility affiliations

  • Anderson Regional Medical Center South Campus Hospital, Meridian, MS, CCN 250081
  • Anderson Regional Medical Center Hospital, Meridian, MS, CCN 250104
  • Neshoba County General Hospital Hospital, Philadelphia, MS, CCN 250043
  • Ochsner Rush Hospital Hospital, Meridian, MS, CCN 250069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R882198MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neshoba County General Hospital Current Accepting new patients
The Columbus Orthopaedic Clinic, P.a. CurrentSince Aug 18, 2025 Accepting new patients
The Columbus Orthopaedic Clinic, P.a. CurrentSince Aug 18, 2025 Accepting new patients
Neshoba County General Hospital CurrentSince Jan 1, 2025 Accepting new patients
Neshoba County General Hospital CurrentSince Jan 1, 2025 Accepting new patients
The Columbus Orthopaedic Clinic, P.a. Past Accepting new patients

Locations

670 Leigh Dr
Columbus, MS 39705
Phone (662) 327-4540

1102 Constitution Ave
Meridian, MS 39301
Phone (601) 693-2511

1102 Constitution Ave
Fl 5
Meridian, MS 39301
Phone (601) 703-5600

1001 Holland Ave
Philadelphia, MS 39350
Phone (601) 663-1200

Interoperability endpoints

  • Direct secure messaging: katelynmoffett@neshobahealth.cernerdirect.com

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 3

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": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1972875995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CONSTITUTION AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014001",
            "telephone_number": "601-703-5600",
            "fax_number": "601-703-5691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CONSTITUTION AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014001",
            "telephone_number": "601-683-3117",
            "fax_number": "601-683-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFETT",
        "first_name": "KATELYN",
        "middle_name": "REBECCA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R882198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04584751",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.