Shawn C Anderson, DO
Individual provider Active NPI Family Medicine Physician · Meridian, MS
NPI 1003831397 · NPPES record last updated Oct 25, 2024
Key facts
- NPI
- 1003831397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 16163 (MS)
- Practice address
- 2024 15TH St FL 2
Meridian, MS 39301-4130 - Phone
- (601) 553-2000
- Fax
- (601) 553-6873
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 8
Owned or controlled facilities with NPI records 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- R Franklin University of Med & Sci/Chicago Medical School, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anderson Physician Alliance Inc
Practice addresses (Care Compare)
2024 15TH St
FL 2
Meridian, MS 39301-4130
Phone (601) 553-2000
Hospital & facility affiliations
- Deaconess Homecare- Region I
- Centerwell Home Health
- Accentcare Home Health of Carthage
- Adoration Home Health
- Harpers Hospice Care Inc
- Anderson Regional Medical Center
- Ochsner Rush Hospital
- Ochsner Watkins Hospital
- Neshoba County General Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
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: Yes
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Anderson Regional Medical Center |
Hospital | Corporate Director | Sep 11, 2001 |
| Baptist Anderson Regional Medical Center - South |
Hospital | Corporate Director Operational/Managerial Control |
Jan 1, 2011 Jan 1, 2024 |
| Baptist Anderson Tom C. Maynor Rehabilitation Center |
Hospital | Corporate Director Operational/Managerial Control |
Jan 1, 2011 Jan 1, 2024 |
| Baptist Anderson Senior Behavioral Health Center |
Hospital | Corporate Director Operational/Managerial Control |
Jan 1, 2011 Jan 1, 2024 |
| Baptist Anderson Swing Bed Unit |
Hospital | Corporate Director Operational/Managerial Control |
Jan 1, 2011 Jan 1, 2024 |
| Baptist Anderson Family Medical Center- Enterprise |
Rural health clinic | Corporate Director Operational/Managerial Control |
Jan 1, 2011 Jan 1, 2024 |
| Baptist Anderson Children'S Medical Center |
Rural health clinic | Corporate Director Operational/Managerial Control |
Jun 28, 2013 Jan 1, 2024 |
| Baptist Anderson Family Medical Center- Airpark |
Rural health clinic | Corporate Director Operational/Managerial Control |
Jan 1, 2011 Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080527000508 | MS | Practitioner - Family Practice | 9335238898 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles (3 of 10)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson Physician Alliance, Inc. | Family Medicine | Current |
Accepting new patients |
| Urology Clinic of Meridian, P.a. | Current | Accepting new patients | |
| Meridian Medical Associates, PA | Family Medicine | Current |
Accepting new patients |
Locations
2124 14th St
Meridian, MS 39301
Phone (601) 483-8811
2024 15th St
Fl 2
Meridian, MS 39301
Phone (601) 553-2000
1600 22nd Ave
#3
Meridian, MS 39301
Phone (601) 693-1055
1600 22nd Ave
Meridian, MS 39301
Phone (601) 483-5322
Networks
- TN PPO
- devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
- devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
- AL HMO D-SNP
- AL HMO
- TN PPO C-SNP
- devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
Interoperability endpoints
- shawn.anderson@mer.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/GIGECA/Endpoint/GIGECA
- sanderson626205@direct.bmhcc.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 16163 | MS | Yes |
Addresses
Primary practice location
2024 15TH St FL 2
Meridian, MS 39301-4130
Mailing address
PO Box 749215
Atlanta, GA 30374-9215
Phone (901) 226-3186
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00120272 | Medicaid | MS |
Other providers in Meridian, MS
- Anderson Regional Medical Center
- Anderson Regional Medical Center
- Anderson Regional Medical Center
- Erika Anderson
- Sarah D Anderson
- Katie Lynn Andreacchio
- Stacy Rae Andreacchio
- John C Andy
- Angel Home Care Services
- Angel Home Care Services
All providers in Meridian, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2024. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.