Samimah Shetta Reese
Individual provider Active NPI Family Nurse Practitioner · Lexington, MS
NPI 1003629692 · NPPES record last updated Jan 29, 2025
Key facts
- NPI
- 1003629692
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 907081 (MS)
- Practice address
- PO Box 689
Lexington, MS 39095-0689 - Phone
- (601) 334-4479
- NPI assigned
- Jan 29, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- MDB Behavioral Health Services LLC
Fast Pace Mississippi PLLC
Minor Med Care, LLC
Practice addresses (Care Compare)
1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598
2121 Grand Ave
Yazoo City, MS 39194-2312
Phone (931) 253-1110
2860 McDowell Rd Ext
Jackson, MS 39204-4238
Phone (601) 372-1117
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250424002186 | MS | Practitioner - Nurse Practitioner | 5092231803 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 907081 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uppal Medical Center LLC | Current |
Accepting new patients | |
| MDB Behavioral Health Services LLC | Current |
Accepting new patients | |
| Minor Med Care, LLC | Current |
Accepting new patients | |
| Minor Med Care, LLC | Current |
Accepting new patients |
Locations
1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373
215 Katherine Dr
#A
Jackson, MS 39232
2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 907081 | MS | Yes |
Addresses
Primary practice location
PO Box 689
Lexington, MS 39095-0689
Mailing address
PO Box 689
Lexington, MS 39095-0689
Phone (601) 334-4479
Other providers in Lexington, MS
- Perfectly Imperfect Wig Collection
- Sharon D Pitchford
- Quality Care Staffing
- Calvin Ramsey
- Nadean Randle
- Russell'S Mr Discount Drugs Inc
- Russells Mr Discount Drugs
- Jason Spencer Rutledge
- Max Sanders
- Doris Plunkett Sanford
All providers in Lexington, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.