Individual provider Active NPI

Nathan P Shappley, M.D.

  • Urology Physician
  • Hattiesburg, MS
National Provider Identifier
1164446522
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
06028 Issued in MS
Practice address
101 Aldersgate Cir
Hattiesburg, MS 39402-1301
Phone
(601) 261-5800
Fax
(601) 261-5813
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 06028 MS Primary

Addresses

Primary practice location

101 Aldersgate Cir
Hattiesburg, MS 39402-1301

Mailing address

101 Aldersgate Cir
Hattiesburg, MS 39402-1301
Phone (601) 261-5800

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817000976 MS Practitioner - Urology 4981629748 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
06028MSMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Urology, P. a. CurrentSince Jul 1, 2016 Accepting new patients
Southern Urology Surgery Center, LLC PastSince Jul 1, 2016 Accepting new patients

Locations

139 Fairfield Dr
Hattiesburg, MS 39402
Phone (601) 450-2401

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1164446522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ALDERSGATE CIR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021301",
            "telephone_number": "601-261-5800",
            "fax_number": "601-261-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ALDERSGATE CIR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021301",
            "telephone_number": "601-261-5800",
            "fax_number": "601-261-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPPLEY",
        "first_name": "NATHAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MS",
            "license": "06028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.