Individual provider Active NPI

Victoria Bass Shearer, D.C.

  • Chiropractor
  • Jackson, MS
National Provider Identifier
1235587437
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1259 Issued in MS
Practice address
766 Lakeland Dr Ste B
Jackson, MS 39216-4610
Phone
(601) 982-2916
Fax
(601) 366-2916
NPI assigned
May 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1259 MS Primary

Addresses

Primary practice location

766 Lakeland Dr Ste B
Jackson, MS 39216-4610

Mailing address

766 Lakeland Dr Ste B
Jackson, MS 39216-4610
Phone (601) 982-2916

Other names 1

  • Mrs. Victoria Lynn Bass Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Jackson Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160622000396 MS Practitioner - Chiropractic 7012208069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garvey Wellness Clinic, IncGroup PAC ID 0042432205, 4 clinicians

Practice addresses (Care Compare)

766 Lakeland Dr
Jackson, MS 39216-4610
Phone (601) 982-2916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1259MSMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Garvey Wellness Clinic, Inc. Chiropractor CurrentSince Feb 1, 2021 Accepting new patients
Cefalu Chiropractic Services of Madison, LLC Chiropractor CurrentSince Sep 20, 2022 Accepting new patients

Locations

2470 Flowood Dr
#125
Flowood, MS 39232
Phone (601) 932-9201

766B Lakeland Dr
Jackson, MS 39216
Phone (601) 982-2916

766 Lakeland Dr
#B
Jackson, MS 39216
Phone (601) 366-5998

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1235587437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 LAKELAND DR STE B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164610",
            "telephone_number": "601-982-2916",
            "fax_number": "601-366-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 LAKELAND DR STE B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164610",
            "telephone_number": "601-982-2916",
            "fax_number": "601-366-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "VICTORIA",
        "middle_name": "BASS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jackson",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "766 Lakeland Dr Ste B",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "BASS",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.