Robert Allen Sheely, MD

Key facts

NPI

1104895028

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

17053 (MS)

Practice address

1220 N Shore Pkwy Ste a
Brandon, MS 39047-6383

Phone

(601) 829-2939

Fax

(601) 829-2995

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 7

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

• River Oaks Management Company LLC Family Medicine Physician · Jackson, MS · NPI 1922029040
  Medicare reassignment Care Compare group NPD FAMILY MEDICINE · MS
• Medical Foundation of Central Mississippi, Inc. Internal Medicine Physician · Jackson, MS · NPI 1992774814
  Medicare reassignment NPD FAMILY MEDICINE · MS
• Careplus Lakeview Family Medicine Family Medicine Physician · Clinton, MS · NPI 1942621024
  NPD FAMILY MEDICINE
• Medical Foundation of Central Ms Family Medicine Physician · Brandon, MS · NPI 1114264264
  NPD FAMILY MEDICINE
• Reservoir Family Medical Clinic, PA Family Medicine Physician · Flowood, MS · NPI 1770929713
  NPD FAMILY MEDICINE
• River Oaks Management Company, LLC Hospitalist Physician · Jackson, MS · NPI 1235329038
  NPD
• First Intermed Corporation Family Medicine Physician · Brandon, MS · NPI 1932133931
  NPD (past) FAMILY MEDICINE

Hospital & facility affiliations 4

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

• Mississippi Baptist Medical Center, Inc. General Acute Care Hospital · Jackson, MS · NPI 1710909585
  Care Compare affiliation Hospital
• River Oaks Hospital LLC General Acute Care Hospital · Flowood, MS · NPI 1396792032
  Care Compare affiliation Hospital
• Roh LLC Women's Hospital · Jackson, MS · NPI 1285681841
  Care Compare affiliation Hospital
• St Dominic-Jackson Memorial Hospital General Acute Care Hospital · Jackson, MS · NPI 1306876065
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Family Practice

Education

University of Mississippi School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

River Oaks Management Company LLC (35 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health River Oaks Hospital · Flowood, MS · CCN 250138
• St Dominic-Jackson Memorial Hospital Hospital · Jackson, MS · CCN 250048
• Mississippi Baptist Medical Center Hospital · Jackson, MS · CCN 250102
• Merit Health Women'S Hospital Hospital · Flowood, MS · CCN 250136

Merit-based Incentive Payment System (MIPS)

Final score

88.07 of 100 (apm)

Quality

73.89

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles (7 of 8)

Locations

Networks

• LA PPO C-SNP

Interoperability endpoints

• Direct secure messaging: robert.sheely.jr.1@4695.direct.athenahealth.com
• Direct secure messaging: robert.sheely.jr.2@4695.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/7115/brand/1/csg/1/fhir/r4

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 18, 2020.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1104895028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N SHORE PKWY STE A",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390476383",
            "telephone_number": "601-829-2939",
            "fax_number": "601-829-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N SHORE PKWY STE A",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390476383",
            "telephone_number": "601-829-2939",
            "fax_number": "601-829-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEELY",
        "first_name": "ROBERT",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "17053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7431317",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00074718",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1ST CHOICE",
            "identifier": "753068151",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS PHYSICIANS CARE NETWOR",
            "identifier": "753068151",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "168390707",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS HEALTH PARTNERS",
            "identifier": "753068151",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "753068151002",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126023",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.sheely.jr.1@4695.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1220 N Shore Pkwy Ste A",
            "city": "Brandon",
            "state": "MS",
            "country_code": "US",
            "postal_code": "390476383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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