Individual provider Active NPI

Sheila Darlene Davidson, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1245521665
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
699691 Issued in MS
Practice address
1704 23Rd Avenue
Meridian, MS 39301
Phone
(601) 485-5081
Fax
(601) 553-6176
NPI assigned
Apr 20, 2011
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R699691 MS
Family Nurse Practitioner 363LF0000X 699691 MS Primary

Addresses

Primary practice location

1704 23Rd Avenue
Meridian, MS 39301

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401
Phone (877) 348-1281

Other practice location 1

2124 14th St
Meridian, MS 39301-4040
Phone (601) 553-6000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190913000778 MS Practitioner - Nurse Practitioner 2769789122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Regional Medical CenterGroup PAC ID 4284548025, 18 clinicians

Practice addresses (Care Compare)

1704 23Rd Ave
Meridian, MS 39301-3103
Phone (601) 485-5081

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R699691MSMDNurse Practitioner
699691MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Regional Medical Center CurrentSince Aug 1, 2019 Accepting new patients
Meridian Hma LLC Past Accepting new patients
Russell Scott Anderson MD PA PastSince Aug 1, 2019 Accepting new patients
Anderson Regional Medical Center Past Accepting new patients

Locations

1102 Constitution Ave
Meridian, MS 39301
Phone (601) 693-2511

1704 23rd Ave
Meridian, MS 39301
Phone (601) 485-5081

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1245521665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "877-348-1281",
            "fax_number": "901-227-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 23RD AVENUE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "39301",
            "telephone_number": "601-485-5081",
            "fax_number": "601-553-6176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2124 14th St",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393014040",
            "country_code": "US",
            "telephone_number": "601-553-6000",
            "fax_number": "601-703-0124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "SHEILA",
        "middle_name": "DARLENE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-20",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R699691",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "699691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.