Hart Katherine Wylie, PMHNP, LPC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Jackson, Mississippi. Her current practice location is
1855 Lakeland Dr, Suite P-121, Jackson, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 366-4696.
Hart Katherine Wylie is licensed to practice in Mississippi (license number R883581) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1053639088.
Healthcare Provider's Profile
| Full Name | Hart Katherine Wylie |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 1855 Lakeland Dr, Jackson, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1053639088
- Provider Enumeration Date: 05/14/2010
- Last Update Date: 09/19/2012
Medicare PECOS Information:
- PECOS PAC ID: 3375818206
- Enrollment ID: I20230125000528
Medical Identifiers
Medical identifiers for Hart Katherine Wylie such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1053639088 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YP2500X | Counselor - Professional | 1360 (Mississippi) | Secondary |
| 106H00000X | Marriage & Family Therapist | T0434 (Mississippi) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | R883581 (Mississippi) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Hart Katherine Wylie allows following entities to bill medicare on her behalf.
| Entity Name | State Of Mississippi - University Of Mississippi Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154317527
PECOS PAC ID: 1850293036
Enrollment ID: O20090414000575 |
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| Entity Name | North Mississippi Primary Health Care Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1821092552
PECOS PAC ID: 3274513528
Enrollment ID: O20100414000677 |
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| Entity Name | Mcclendon Medical Clinic Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053782755
PECOS PAC ID: 6103129945
Enrollment ID: O20160128000276 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Hart Katherine Wylie is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Hart Katherine Wylie, PMHNP, LPC
1855 Lakeland Dr, Suite P-121,
Jackson, MS 39216-4913
Ph: (601) 366-4696 | Hart Katherine Wylie, PMHNP, LPC
1855 Lakeland Dr, Suite P-121,
Jackson, MS 39216-4913
Ph: (601) 366-4696 |
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