Individual provider Active NPI

Shedrieka Maye

  • Psychiatric/Mental Health Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1245987098
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
905213 Issued in MS
Practice address
5001 Hardy St
Hattiesburg, MS 39402-1308
Phone
(601) 268-8029
Fax
(601) 268-8394
NPI assigned
Mar 2, 2022
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 905213 MS Primary

Addresses

Primary practice location

5001 Hardy St
Hattiesburg, MS 39402-1308

Mailing address

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 288-8029

Other identifiers 2

IdentifierTypeStateIssuer
905213OtherMSLICENSE VERIFICATION
2021231404OtherMSAACC

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
I20220419002918 MS Practitioner - Nurse Practitioner 2961899067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wesley Physician Services LLCGroup PAC ID 2466559851, 42 clinicians

Practice addresses (Care Compare)

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 268-8155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Physician Services LLC CurrentSince Mar 21, 2022 Accepting new patients

Locations

5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1930/brand/2/csg/102/fhir/r4

Organizations & group practices 1

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 1

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": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1245987098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-288-8029",
            "fax_number": "601-268-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8029",
            "fax_number": "601-268-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYE",
        "first_name": "SHEDRIEKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "905213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE VERIFICATION",
            "identifier": "905213",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AACC",
            "identifier": "2021231404",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.