Shannon Dobbs, DO
Individual provider Active NPI Emergency Medicine Physician · Ackerman, MS
NPI 1295099455 · NPPES record last updated Jan 22, 2021
Key facts
- NPI
- 1295099455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 22916 (MS)
- Practice address
- 8613 Ms Highway 12
Ackerman, MS 39735-8917 - Phone
- (662) 285-4400
- NPI assigned
- Jul 2, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Philadelphia College of Osteopathic Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Choctaw Regional Medical Center
Practice addresses (Care Compare)
8613 Ms Hwy 12
Ackerman, MS 39735-8917
Phone (662) 285-9460
Hospital & facility affiliations
- Choctaw Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MS, AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141021000806 | MS | Practitioner - Emergency Medicine | 5395966121 | Reassigns benefits to 3 organizations |
| I20200129002946 | AL | Practitioner - Emergency Medicine | 5395966121 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22916 | MS | MD | Emergency Medicine Physician |
| DO.1681 | AL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choctaw Regional Medical Center | Current |
Accepting new patients | |
| Pontotoc Health Services, Inc. | Current |
Accepting new patients | |
| Correct Care, Inc. | Emergency Medicine | Current |
Accepting new patients |
| Choctaw Regional Medical Center | Family Medicine | Current | Accepting new patients |
| Pontotoc Health Services, Inc. | Current |
Accepting new patients |
Locations
211 Hospital Rd
Red Bay, AL 35582
Phone (256) 356-8160
229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225
64 N Louisville St
Ackerman, MS 39735
Phone (662) 285-9050
8613 MS Highway 12
Ackerman, MS 39735
Phone (662) 285-4400
176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/chocrmc-b09bb3d6
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | DO.1681 | AL | |
| Family Medicine Physician | 207Q00000X | DO.1681 | AL | |
| Family Medicine Physician | 207Q00000X | 22916 | MS | |
| Emergency Medicine Physician | 207P00000X | 22916 | MS | Yes |
Addresses
Primary practice location
8613 Ms Highway 12
Ackerman, MS 39735-8917
Mailing address
110 Whitney Cir
Vincent, AL 35178-9464
Other practice location 1
8613 MS Highway 12
Ackerman, MS 39735-8917
Phone (662) 285-9460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01975826 | Medicaid | MS |
Other providers in Ackerman, MS
- Clarity Counseling Group LLC
- Sylvia Crutchfield
- Brittany Dempsey Dickerson
- Discount Drugs of Ms LLC
- Betty Ann Dobbs
- Jan Ganann
- Reginald Gandy
- Shunda Lynette Garner
- Celeste Prather Hamous
- Angela Ann Hays
All providers in Ackerman, MS · Emergency Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.