Jason Lee Shives, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21360 Issued in MS

Practice address

102 Shelby Speights Dr
Purvis, MS 39475-4151

Phone

(601) 794-8065

Fax

(601) 794-5650

NPI assigned

Nov 25, 2009

Last updated

Nov 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, PA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RH Hospitalist Medicine of Walthall General LLCGroup PAC ID 2365881091, 16 clinicians

RH Emergency Medicine of Walthall General LLCGroup PAC ID 7517306830, 7 clinicians

RH Emergency Medicine of Pearl River LLCGroup PAC ID 9032562384, 5 clinicians

Relias Emergency Medicine Specialists of Hattiesburg LLCGroup PAC ID 9032549142, 46 clinicians

Emergency Physician Associates of Pennsylvania PCGroup PAC ID 5597663252, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
• Marion General Hospital Hospital, Columbia, MS, CCN 250085
• Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030
• Pearl River County Hospital Hospital, Poplarville, MS, CCN 251333

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Relias Emergency Medicine Specialists of Hattiesburg LLC

  • Emergency Medicine Physician
  • Hattiesburg, MS
  • NPI 1609409440
  Medicare reassignment Care Compare group NPD
• RH Emergency Medicine of Pearl River LLC

  • Emergency Medicine Physician
  • Poplarville, MS
  • NPI 1265206544
  Medicare reassignment Care Compare group NPD
• RH Emergency Medicine of Walthall General LLC

  • Emergency Medicine Physician
  • Tylertown, MS
  • NPI 1336901511
  Medicare reassignment Care Compare group NPD
• RH Hospitalist Medicine of Walthall General LLC

  • Hospitalist Physician
  • Tylertown, MS
  • NPI 1053173237
  Medicare reassignment Care Compare group NPD
• Emergency Physician Associates of Pennsylvania, PC

  • Emergency Medicine Physician
  • Hanover, PA
  • NPI 1619990900
  Medicare reassignment Care Compare group NPD
• Keystone Medical Services of Ms, Inc

  • Emergency Medicine Physician
  • Hazlehurst, MS
  • NPI 1174691059
  Medicare reassignment NPD
• RH Emergency Medicine of Highland Community LLC

  • Emergency Medicine Physician
  • Picayune, MS
  • NPI 1033987946
  Medicare reassignment NPD
• RH Emergency Medicine of Jefferson Davis LLC

  • Emergency Medicine Physician
  • Prentiss, MS
  • NPI 1356103527
  Medicare reassignment NPD
• RH Emergency Medicine of Marion General LLC

  • Emergency Medicine Physician
  • Columbia, MS
  • NPI 1841064110
  Medicare reassignment NPD
• RH Emergency Medicine of Perry County LLC

  • Emergency Medicine Physician
  • Richton, MS
  • NPI 1740058650
  Medicare reassignment NPD
• RH Hospitalist Medicine of Jefferson Davis LLC

  • Hospitalist Physician
  • Prentiss, MS
  • NPI 1174385355
  Medicare reassignment NPD
• Emergency Care Services of Pennsylvania, P.C.

  • Emergency Medicine Physician
  • Langhorne, PA
  • NPI 1114955010
  Medicare reassignment NPD

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

• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation
• Forrest County General Hospital

  dba Marion General Hospital

  • General Acute Care Hospital
  • Columbia, MS
  • NPI 1427320993
  Care Compare affiliation
• Forrest County General Hospital

  dba Pearl River County Hospital & Nursing Home

  • Critical Access Hospital
  • Poplarville, MS
  • NPI 1760789903
  Care Compare affiliation
• Lehigh Valley Hospital - Schuylkill

  dba Lehigh Valley Hospital Schuylkill S Jackson Street

  • Rural Acute Care Hospital
  • Pottsville, PA
  • NPI 1235138405
  Care Compare affiliation
• Schuylkill Medical Center - East Norweigan Street

  • General Acute Care Hospital
  • Pottsville, PA
  • NPI 1427050376
  Care Compare affiliation

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1083942338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SHELBY SPEIGHTS DR",
            "city": "PURVIS",
            "state": "MS",
            "postal_code": "394754151",
            "telephone_number": "601-794-8065",
            "fax_number": "601-794-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SHELBY SPEIGHTS DR",
            "city": "PURVIS",
            "state": "MS",
            "postal_code": "394754151",
            "telephone_number": "601-794-8065",
            "fax_number": "601-794-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVES",
        "first_name": "JASON",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-25",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME102839",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD470029",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "21360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farrah Richards
• Yuri Olaf Rivera, PA-C
• Bailey Robichaux, PCCSS
• Sassafras Hill Counseling Center, Inc
• Allison Scott, LMSW
• Susan M Sicotte, CNP
• Nylisha Simmons
• Allison Smith, LMSW
• Joyce Ann Smith, PT, DPT
• Kaylee C Smith, PCMHT

• Family Medicine Physician in Purvis, MS
• Providers in Purvis, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.