Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Katharyn Mary

Individual provider Physician Assistant · NPI 1194512061

Katharyn Mary is a Physician Assistant in Hattiesburg, Mississippi. Qualified in 2025, 1 year ago. Practices with Hattiesburg Clinic PA, a 530-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
1
Licensed in
MS
In the registry since
2025
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Practice location Address checks out

415 S 28th Ave
Hattiesburg, MS 39401-7246
Phone: (601) 268-5650
Fax: (601) 579-5212
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA00912 (MS)

Record details

NPI number1194512061
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 23, 2025
Last updated in NPPESJuly 29, 2025
Certification dateJuly 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Hattiesburg Clinic Pa — 530 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Hattiesburg