NPIMap

Individual provider Active NPI

Nicole Victoria Shioli Baxter, NP

  • Family Nurse Practitioner
  • Long Beach, MS
National Provider Identifier
1053147579
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906762 Issued in MS
Practice address
110 E Railroad St
Long Beach, MS 39560-4625
Phone
(228) 678-7036
NPI assigned
Sep 11, 2024
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 906762 MS Primary

Addresses

Primary practice location

110 E Railroad St
Long Beach, MS 39560-4625

Mailing address

548 W Beach Blvd Apt 129
Long Beach, MS 39560-5965
Phone (228) 678-7036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241008000671 MS Practitioner - Nurse Practitioner 2567993074 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians
LHCG CXCV, LLCGroup PAC ID 7113322009, 5 clinicians

Practice addresses (Care Compare)

110 E Railroad St
Long Beach, MS 39560-4625
Phone (228) 678-7036

1641 A Popps Ferry Rd
6 Deaconess Palliative Care
Biloxi, MS 39532-2226
Phone (228) 207-4128

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 15, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Sep 1, 2024 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 15, 2025 Accepting new patients
LHCG CXCV, LLC CurrentSince Apr 1, 2025 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

1641 Popps Ferry Rd
#A6
Biloxi, MS 39532

1641 Popps Ferry Rd
Ste A6
Biloxi, MS 39532
Phone (228) 207-4128

2798 Pass Rd
Biloxi, MS 39531
Phone (228) 200-0340

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 64

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 64

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1053147579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 W BEACH BLVD APT 129",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395605965",
            "telephone_number": "228-678-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E RAILROAD ST",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395604625",
            "telephone_number": "228-678-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIOLI BAXTER",
        "first_name": "NICOLE",
        "middle_name": "VICTORIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, MS

Sources for this page

Verify at the official NPI Registry.