Shara Smith Bledsoe, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R874322 Issued in MS

Practice address

2778 Highway 51 S
Senatobia, MS 38668-9403

Phone

(662) 560-5966

Fax

(662) 560-5969

NPI assigned

Jun 28, 2012

Last updated

Sep 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Archipoimen PLLC

  dba Bagwell Medical Clinic

  • Clinic/Center
  • Hernando, MS
  • NPI 1881119618
  Medicare reassignment NPD
• Associated Family Medical, LLC

  • Nurse Practitioner
  • Senatobia, MS
  • NPI 1194054304
  NPD

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1063776607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2778 HIGHWAY 51 S",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386689403",
            "telephone_number": "662-560-5966",
            "fax_number": "662-560-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2778 HIGHWAY 51 S",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386689403",
            "telephone_number": "662-560-5966",
            "fax_number": "662-560-5969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2416 Mount Pleasant Rd",
            "address_purpose": "LOCATION",
            "city": "Hernando",
            "state": "MS",
            "postal_code": "386322001",
            "country_code": "US",
            "telephone_number": "662-560-5966",
            "fax_number": "662-560-5969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "SHARA",
        "middle_name": "SMITH",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R874322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09028791",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savannah Simpson Barnes, DNP, FNP-C
• Julie Baumann, PHARMD
• Better Days Home and Personal Care LLC
• Margaret (Lisa) Scott Billingsley, M.S.CCC-SLP
• Patricia Blair, FPNP
• Kyle Avery Blount, DPT
• Makena Boehm
• Presleigh Box, COTA/L
• Kimberly S Bradley, PHARMD
• Ashley Clinkscales Brewer, DPT

• Family Nurse Practitioner in Senatobia, MS
• Providers in Senatobia, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.