NPIMap

Individual provider Active NPI

Shanita Peoples, CRNP

  • Acute Care Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1124659487
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-126986 Issued in AL
Practice address
23 Midtown Park W Ste B-1
Mobile, AL 36606-4139
Phone
(251) 295-5110
Fax
(251) 378-8248
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-126986 AL Primary

Addresses

Primary practice location

23 Midtown Park W Ste B-1
Mobile, AL 36606-4139

Mailing address

23 Midtown Park W Ste B-1
Mobile, AL 36606-4139
Phone (251) 295-5110

Other practice location 1

2260 Pesnell Ct Apt 5B
Mobile, AL 36695-3803
Phone (251) 295-5110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200307000154 AL Practitioner - Nurse Practitioner 8628406568 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Home Care Services LLC 101 clinicians

Practice addresses (Care Compare)

2800 Dauphin St
Suite 103
Mobile, AL 36606-2400
Phone (251) 478-2789

Hospital & facility affiliations

  • Aveanna Home Health Home health agency, Foley, AL, CCN 017034
  • Centerwell Home Health Home health agency, Mobile, AL, CCN 017168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Russellville Hospital Inc CurrentSince Sep 1, 2024 Accepting new patients
Eastern Hospital Medicine PC CurrentSince Sep 1, 2024 Accepting new patients
Bay Area Community Medicine, PC CurrentSince Jul 1, 2020 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Oct 3, 2024 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Oct 3, 2024 Accepting new patients
Eastern Hospital Medicine PC CurrentSince Sep 1, 2024 Accepting new patients
Russellville Hospital Inc CurrentSince Sep 1, 2024 Accepting new patients

Locations

50 Medical Park Dr E
Birmingham, AL 35235
Phone (205) 838-3000

2431 W Main St
Ste 1102
Dothan, AL 36301
Phone (334) 699-5780

2740 Headland Ave
Dothan, AL 36303
Phone (334) 792-3200

2800 Dauphin St
Ste 103
Mobile, AL 36606
Phone (251) 478-2789

3737 Government Blvd
Ste 408
Mobile, AL 36693
Phone (251) 602-1911

15225 Highway 43
Ste I
Russellville, AL 35653
Phone (256) 331-2700

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1124659487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MIDTOWN PARK W STE B-1",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064139",
            "telephone_number": "251-295-5110",
            "fax_number": "251-378-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MIDTOWN PARK W STE B-1",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064139",
            "telephone_number": "251-295-5110",
            "fax_number": "251-378-8248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2260 Pesnell Ct Apt 5B",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366953803",
            "country_code": "US",
            "telephone_number": "251-295-5110",
            "fax_number": "251-378-8248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEOPLES",
        "first_name": "SHANITA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-126986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.