Shekela Douglas, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

904237 Issued in MS

Practice address

105 Executive Dr Ste a
Madison, MS 39110-8496

Phone

(601) 540-5900

Fax

(228) 263-3904

NPI assigned

Aug 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uppal Medical Center LLCGroup PAC ID 4587998547, 129 clinicians

MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Uppal Medical Center LLC

  • Rural Health Clinic/Center
  • Greenville, MS
  • NPI 1558927905
  Medicare reassignment Care Compare group NPD
• MDB Behavioral Health Services LLC

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  Medicare reassignment Care Compare group
• Peace of Mind Health and Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Madison, MS
  • NPI 1245103217
  NPD Authorized official
• Minor Med Care, LLC

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1407968738
  Medicare reassignment
• Minor Med Care, LLC

  • Rural Health Clinic/Center
  • Raymond, MS
  • NPI 1669575627
  NPD

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1306511225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 CALHOUN STATION PKWY STE C",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391105541",
            "telephone_number": "601-540-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 EXECUTIVE DR STE A",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108496",
            "telephone_number": "601-540-5900",
            "fax_number": "228-263-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SHEKELA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "904237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Dixon, PHARM.D.
• Madina C Dixon, NP
• Brenda B Donald, LCSW, BCD
• Vanessa Dorado, M.S., OTR/L, SLP-A
• Morgan Ariel Doty Moody, APRN
• Sumner B Douglas, NP
• Tracey Lamar Douglas, DMD
• Dra Health Services LLC
• Austin Drake, LAT, ATC
• Emily Melissa Draper, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Madison, MS
• Providers in Madison, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.
• 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.