KATIE PENDLETON (FNP-C) – Family Nurse Practitioner, NPI 1437042157
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,566 NURSE PRACTITIONER in MS
Provider Addresses for KATIE PENDLETON (FNP-C)
PO BOX 649113
DALLAS, TX 752649113
Phone: (855) 343-5763
Fax: (855) 343-5763
Type: Mailing
120 STONE CREEK BLVD
FLOWOOD, MS 392328205
Phone: (601) 420-2040
Type: Location
114 Byram Business Center Dr
Byram, MS 392729636
Phone: (601) 883-6304
Fax: (601) 883-6325
Type: Location
220 Highway 12 W
Kosciusko, MS 390903208
Phone: (662) 289-4311
Fax: (662) 290-3255
Type: Location
7100 U S Highway 98 Ste 210
Hattiesburg, MS 394028557
Phone: (601) 545-7021
Fax: (601) 545-6978
Type: Location
27190 Highway 28
Hazlehurst, MS 390832224
Phone: (601) 574-7277
Fax: (601) 420-2356
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250714003106 | I | Nurse Practitioner | MS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75264)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Pain Management | LA | |
| Interventional Pain Management, Anesthesiology | MS | |
| Pain Management | MS | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS | |
| Pain Management, Anesthesiology | OK | |
| Nurse Practitioner | TN | |
| Physical Medicine And Rehabilitation, Pain Management | TN | |
| Interventional Pain Management, Anesthesiology | TX |
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