Shonda Jacqueline Phelon, C.F.N.P.; P.M.H.N.P

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R734347 Issued in MS

Practice address

1970 Grandview Dr
Grenada, MS 38901-5066

Phone

(662) 227-3700

Fax

(662) 227-3740

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Region VI Community Mental Health Commission

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenwood, MS
  • NPI 1154433233
  NPD
• Garden Park

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenwood, MS
  • NPI 1932437209
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1194947754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1505",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389351505",
            "telephone_number": "662-453-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 GRANDVIEW DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389015066",
            "telephone_number": "662-227-3700",
            "fax_number": "662-227-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELON",
        "first_name": "SHONDA",
        "middle_name": "JACQUELINE",
        "credential": "C.F.N.P.; P.M.H.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R734347",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R734347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Mississippi Foot Specialists PC
• Ronald J Okabe, PT
• James Walter Parrett Jr., PHARM.D.
• Elizabeth Annette Patton, PHARM D
• James Michael Pegg, O.D.
• James R Philley, DMD
• Physicians and Surgeons
• Karen W Plunkett, M.D.
• Felicia Faye Poe, D.C.
• Kimberly Paige Porter, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Grenada, MS
• Providers in Grenada, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.