Active NPI
Shalisa Donnay Scott
- Nurse's Aide
- Pine Bluff, AR
National Provider Identifier
1053139147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- AR014071701382
- Practice address
- 3021 S Fir St Apt 4
Pine Bluff, AR 71603-5665 - Phone
- (479) 407-9101
- NPI assigned
- Sep 28, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | AR014071701382 | AR | Primary |
Addresses
Primary practice location
3021 S Fir St Apt 4
Pine Bluff, AR 71603-5665
Mailing address
6109 Timber Ridge Dr
Pine Bluff, AR 71603-7713
Phone (479) 407-9101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AR014071701382 | AR | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1053139147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6109 TIMBER RIDGE DR",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716037713",
"telephone_number": "479-407-9101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3021 S FIR ST APT 4",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716035665",
"telephone_number": "479-407-9101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "SHALISA",
"middle_name": "DONNAY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-28",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "AR",
"license": "AR014071701382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.