Shalitha Ervin, CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

73437 Issued in MS

Practice address

3127 Greenfield Rd Lot 271
Pearl, MS 39208-7000

Phone

(601) 862-2676

NPI assigned

Aug 29, 2022

Sex

Female

Sole proprietor

No

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.

• Miss Shay'S Guardian Angels, LLC

  • Home Health Agency
  • Pearl, MS
  • NPI 1023738473
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 29, 2022.

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1114647567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 GREENFIELD RD LOT 271",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392087000",
            "telephone_number": "601-862-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3127 GREENFIELD RD LOT 271",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392087000",
            "telephone_number": "601-862-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "SHALITHA",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MS",
            "license": "73437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destin Community Care Inc
• Destin Community Care,Inc
• Divinity Pediatric Clinic, PLLC
• Wilma Dixon
• D. Jason Eklund, D.M.D. P.A.
• Essilor Laboratories of America, Inc
• Carleen Evans
• Ronequa Evans, NP-C
• Family Health Care Clinic, Inc.
• First Intermed Corporation

• All providers in Pearl, MS
• Nurse's Aide in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.