Shantrice Bernice Nichols-Bates, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

901369 Issued in MS

Practice address

350 W Woodrow Wilson Ave Ste 1010
Jackson, MS 39213-7681

Phone

(769) 366-4719

Fax

(769) 366-4717

NPI assigned

Nov 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shantrice.nichols-bates@1078078150082564.direct.elationemr.com

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.

• Journeycare Family Medicine, LLC

  • Family Nurse Practitioner
  • Fayetteville, GA
  • NPI 1932808094
  Medicare reassignment NPD Authorized official
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment NPD
• Py Medical Services of Ga PC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1790541647
  Medicare reassignment NPD
• Wellbe Senior Medical Group of Georgia, P. C.

  • Internal Medicine Physician
  • Sandy Springs, GA
  • NPI 1205463163
  Medicare reassignment NPD
• Journeycare Medical, LLC

  • Primary Care Nurse Practitioner
  • Jackson, MS
  • NPI 1245170885
  NPD Authorized official
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1245603844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE STE 1010",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "769-366-4719",
            "fax_number": "769-366-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE STE 1010",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "769-366-4719",
            "fax_number": "769-366-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS-BATES",
        "first_name": "SHANTRICE",
        "middle_name": "BERNICE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201508267NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901369",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP000049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip T Nguyen, M.D.
• Phuong Khanh Trong Nguyen, PHARM.D.
• Tram Hong Nguyen
• William Clyde Nicholas, MD
• Donnell Nicholes Jr
• Harold Nichols, CRNA
• James R Nichols III, D.O.
• Meghan Elizabeth Nichols, NP
• Michael R Nichols, D.M.D., M.D.
• Todd Applewhite Nichols, MD

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; 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.