KATELYN ROSSOW MD NPI 1790102788

NPI Information

  • NPI: 1790102788
  • Provider Name: KATELYN ROSSOW, MD
  • Classification: Pediatrics - 2080P0006X
  • Specialization: Developmental - Behavioral Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2500 N STATE ST
    JACKSON, MS
    ZIP 39216
  • Phone: (502) 588-0850

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NPI Details

Katelyn Rossow, MD is a developmental - behavioral pediatrics pediatrics in Jackson, MS with 6 years of experience. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. Katelyn Rossow, MD NPI is 1790102788. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2500 N STATE ST
JACKSON, MS
ZIP 39216-500
Phone: (502) 588-0850

The NPI 1790102788 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/27/2014 and was last updated on 7/15/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics55729KENTUCKYNo
2208000000XPediatrics01079254AINDIANANo
32080P0006XPediatricsDevelopmental - Behavioral Pediatrics01079254AINDIANANo
42080P0006XPediatricsDevelopmental - Behavioral Pediatrics56397TENNESSEENo
52080P0006XPediatricsDevelopmental - Behavioral Pediatrics55729KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17100660090MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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