KATHERINE RAE HERNDON (NPI# 1649871682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649871682 |
| Entity Type | Individual |
| Full Name | KATHERINE RAE HERNDON |
| Credential | PA-C |
| Practice Address |
2525 Telephone Rd Pascagoula MS 39567-3202 |
| Mailing Address |
9370 Oak Island Rd Gulfport MS 39503-7054 |
| Practice Telephone | 6013258094 |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA00512 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447790373 | Katherine Herndon | Massage Therapist | 2366 Eastlake Ave E, Seattle, WA 98102-3366 | 2017-02-25 |
| 1063593689 | Katherine M. Herndon | Nurse Practitioner | 1515 Holcombe Blvd, Houston, TX 77030-4009 | 2006-10-18 |
| Street Address |
2525 TELEPHONE RD |
| City | PASCAGOULA |
| State | MS |
| Zip Code | 39567-3202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174583496 | David Milton Jenkins | Surgery | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2006-03-23 |
| 1295382828 | Lashaunda Whitley | Nurse Practitioner | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2019-08-19 |
| 1083124143 | Alejandra Diaz | Physician Assistant | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2017-10-03 |
| 1366989253 | Anna Kahlmus | Nurse Practitioner | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2017-01-30 |
| 1942747266 | Maggie Emerson Duke | Nurse Practitioner | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2017-01-24 |
| 1629514286 | Tracie George | Nurse Practitioner | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2017-01-06 |
| 1235473950 | South Mississippi Urology Pllc | Urology | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2012-11-19 |
| 1477723252 | Jason Payne | Surgery | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2008-03-07 |
| 1528249554 | Jeremy J Simpler | Surgery | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2007-11-19 |
| 1114126042 | Nicholas John Fayard | Surgery | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2007-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316439615 | Quad/med, LLC | Clinic/Center | 1000 Jere St. Pe' Hwy, C/o Ingalls Main Substation, 1st Floor, Pascagoula, MS 39567 | 2018-06-01 |
| 1477948107 | Market Place Pharmacy, LLC | Pharmacy | 1965 Market Street, Pascagoula, MS 39567 | 2015-03-31 |
| 1518382266 | Randy S Kirksey | Social Worker | 1017 Farnworth Ave, Pascagoula, MS 39567 | 2014-03-04 |
| 1063710747 | Hinman Chiropractic Care, Pa | Chiropractor | 3215 Market Street, Pascagoula, MS 39567 | 2011-03-04 |
| 1215232830 | Jessica E Shores | Military Health Care Provider | 1000 Access Rd Bldg 2026, Pascagoula, MS 39567 | 2011-01-12 |
| 1912214438 | Walker Chiropractic Center, Pllc | Chiropractor | 1408 Ingalls Ave, Pascagoula, MS 39567 | 2010-09-03 |
| 1386979961 | South Mississippi Ear, Nose and Throat | Otolaryngology | 2525 Telephone Road, Pascagoula, MS 39567 | 2009-10-15 |
| 1720299415 | James H Halbrook | Dentist | 2202 Old Mobile Hwy, Pascagoula, MS 39567 | 2007-05-24 |
| 1871624627 | Thayne Christopher Griener | Otolaryngology | 2812 Andrews Avenue, Pascagoula, MS 39567 | 2007-03-07 |
| 1447318159 | Ada Ruth Bosarge | Physical Therapist | 2838 Andrew St, Pascagoula, MS 39567 | 2006-12-05 |
| Find all providers in zip 39567 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124143 | Alejandra Diaz | Physician Assistant | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2017-10-03 |
| 1225576820 | Connie Baker Klotzbach | Physician Assistant | 2819 Denny Ave, Pascagoula, MS 39581-5301 | 2017-02-03 |
| 1356796577 | Madison Avara Brown | Physician Assistant | 4105 Hospital St Ste 112b, Pascagoula, MS 39581-5304 | 2016-04-25 |
| 1093139040 | Complete Health Urgicare, Inc | Physician Assistant | 4211 Hospital St, Suite 101, Pascagoula, MS 39581-5320 | 2014-02-11 |
| 1598016701 | Allison A Garstecki | Physician Assistant | 4105 Hospital St, Suite 112b, Pascagoula, MS 39581-5312 | 2012-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831703958 | Melanie Layne Mccoy | Physician Assistant | 202 Joyce Ave, Long Beach, MS 39560-4332 | 2020-09-04 |
| 1437785482 | Kimberly Jordan Tupper | Physician Assistant | 6371 Shenandoah Ln, Olive Branch, MS 38654-3425 | 2020-03-20 |
| 1700419041 | Alexander Sorokin Flecker | Physician Assistant | 200b Eager St, Clinton, MS 39056-4545 | 2020-02-14 |
| 1548892904 | Meghan Seymour | Physician Assistant | 510 Glensview Dr, Brandon, MS 39047-7919 | 2020-02-04 |
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1477190668 | Kimberly Mcraney Watson | Physician Assistant | 907 Oakhill Cir, Clinton, MS 39056-3743 | 2019-12-06 |
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1467097956 | Chandler Stengel | Physician Assistant | 7900 Airways Blvd., Ste B102, Southaven, MS 38671-5809 | 2019-11-08 |
| 1922653526 | Lauren Ramsey | Physician Assistant | 845 E Scenic Dr, Pass Christian, MS 39571-4624 | 2019-08-09 |
| 1972161891 | Allison Taylor | Physician Assistant | 1850 Chadwick Drive, Suite 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2019-06-05 |
| Find all providers with the same taxonomy | ||||
| City | PASCAGOULA |
| Zip Code | 39567 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.