NPIMap

Individual provider Active NPI

Shelby Swede Phung, MD

  • Family Medicine Physician
  • Philadelphia, MS
National Provider Identifier
1316697170
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.47575 Issued in AL
Practice address
1120 E Main St Ste 1
Philadelphia, MS 39350-2300
Phone
(601) 656-1465
NPI assigned
Mar 25, 2022
Last updated
Jul 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.47575 AL Primary

Addresses

Primary practice location

1120 E Main St Ste 1
Philadelphia, MS 39350-2300

Mailing address

1120 E Main St Ste 1
Philadelphia, MS 39350-2300
Phone (251) 424-1488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250206002026 AL Practitioner - Family Practice 0648700609 Reassigns benefits to 1 organization
I20250718004312 MS Practitioner - Family Practice 0648700609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 Holland Ave
Philadelphia, MS 39350-2161
Phone (601) 663-1269

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Neshoba Physicians Billing Service CurrentSince Aug 1, 2025 Accepting new patients
RH Hospitalist Medicine of Philadelphia LLC CurrentSince Feb 1, 2026 Accepting new patients
Urgent Care by the Bay, LLC CurrentSince Nov 30, 2024 Accepting new patients
Neshoba Physician Billing Service CurrentSince Aug 1, 2025 Accepting new patients
Neshoba County General Hospital Past Accepting new patients
Neshoba County General Hospital Past Accepting new patients

Locations

1208 US Highway 98
Daphne, AL 36526
Phone (251) 626-5377

1001 Holland Ave
Philadelphia, MS 39350
Phone (601) 663-1200

1120 E Main St
Ste 1
Philadelphia, MS 39350
Phone (601) 656-1465

Organizations & group practices 6

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 6

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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1316697170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST STE 1",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502300",
            "telephone_number": "251-424-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST STE 1",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502300",
            "telephone_number": "601-656-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "SHELBY",
        "middle_name": "SWEDE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.47575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

Verify at the official NPI Registry.