Jeanette Shabazz

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R885984 Issued in MS

Practice address

3890 Bienville Blvd
Ocean Springs, MS 39564-5803

Phone

(228) 872-6291

Fax

(228) 875-3385

NPI assigned

Oct 8, 2014

Last updated

Jan 11, 2016By 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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Singing River Health System Hospital, Pascagoula, MS, CCN 250040

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeanetteshabazz@dhc.allscriptsdirect.net

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.

• Baz Family Medical Clinic

  • Family Medicine Physician
  • Pascagoula, MS
  • NPI 1508353384
  Medicare reassignment NPD Authorized official
• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937
  Medicare reassignment NPD

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

• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937

  Hospital

  Care Compare affiliation
• Singing River Health System

  • General Acute Care Hospital
  • Pascagoula, MS
  • NPI 1124136593
  Care Compare affiliation

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1073916771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 HOSPITAL ST",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395814117",
            "telephone_number": "228-769-1035",
            "fax_number": "228-769-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645803",
            "telephone_number": "228-872-6291",
            "fax_number": "228-875-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABAZZ",
        "first_name": "JEANETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R885984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07576018",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Senior Living Ancillary Services
• Martin Senitko, M.D.
• Jeramy Lynn Seymour
• Kelsy Seymour, FNP
• Patricia Seymour, ADTR, LCSW
• Terri F Shannon
• Joye W Shanteau, PH.D.
• Manjari Sharma, MD
• Christy Lynn Shaw, NP
• Laura Shaw, PT, DPT

• Family Nurse Practitioner in Ocean Springs, MS
• Providers in Ocean Springs, 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 Jan 11, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.