NPIMap

Individual provider Active NPI

Kelly Susanne Mask, N.P.

  • Family Nurse Practitioner
  • Pascagoula, MS
National Provider Identifier
1992836423
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R860508 Issued in MS
Practice address
3101 Denny Ave Ste 230
Pascagoula, MS 39581-5307
Phone
(228) 460-4180
Fax
(228) 400-1140
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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 R860508 MS Primary

Addresses

Primary practice location

3101 Denny Ave Ste 230
Pascagoula, MS 39581-5307

Mailing address

3101 Denny Ave Ste 230
Pascagoula, MS 39581-5307
Phone (228) 460-4180

Other names 1

  • Kelly Susanne Stevison Former name

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
I20161228002024 MS Practitioner - Nurse Practitioner 7214228873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

3101 Denny Ave
Pascagoula, MS 39581-5307
Phone (228) 460-4180

3265 Hwy 90
Gautier, MS 39553-5121
Phone (931) 253-1110

7001 Hwy 614
Coastal Ambulatory Services
Hurley, MS 39555-5340
Phone (228) 588-6622

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R860508MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Mississippi, PLLC Family CurrentSince Aug 1, 2022 Accepting new patients
Singing River Health System CurrentSince Dec 22, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Aug 1, 2022 Accepting new patients
Singing River Health System Past Accepting new patients

Locations

2798 Pass Rd
Biloxi, MS 39531
Phone (228) 200-0340

3265 Highway 90
Gautier, MS 39553
Phone (228) 366-9136

15190 Community Rd
Ste 120
Gulfport, MS 39503
Phone (228) 328-2400

3101 Denny Ave
Ste 230
Pascagoula, MS 39581
Phone (228) 460-4180

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

Interoperability endpoints

  • Direct secure messaging: kmask@direct.mysrhs.com

Organizations & group practices 4

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.

Hospital & facility affiliations 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1992836423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 DENNY AVE STE 230",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815307",
            "telephone_number": "228-460-4180",
            "fax_number": "228-400-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 DENNY AVE STE 230",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815307",
            "telephone_number": "228-460-4180",
            "fax_number": "228-400-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASK",
        "first_name": "KELLY",
        "middle_name": "SUSANNE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R860508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "STEVISON",
            "middle_name": "SUSANNE",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.