Individual provider Active NPI

Ivey Burt Shelton, FNP

  • Family Nurse Practitioner
  • Clinton, MS
National Provider Identifier
1407573843
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905570 Issued in MS
Practice address
129 Viewpointe Dr
Clinton, MS 39056-6085
Phone
(601) 527-4465
NPI assigned
Oct 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 905570 MS Primary

Addresses

Primary practice location

129 Viewpointe Dr
Clinton, MS 39056-6085

Mailing address

129 Viewpointe Dr
Clinton, MS 39056-6085
Phone (601) 527-4465

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
I20221203000233 MS Practitioner - Nurse Practitioner 2567831100 Reassigns benefits to 2 organizations

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
Wound Management Specialists LLCGroup PAC ID 5193056364, 157 clinicians

Practice addresses (Care Compare)

1190 N State St
Jackson, MS 39202-2413
Phone (769) 243-6141

Hospital & facility affiliations

  • Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
  • Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
  • Panola Medical Center Hospital, Batesville, MS, CCN 250781
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McFatter Family Medical, LLC CurrentSince Nov 1, 2022 Accepting new patients
Wound Management Specialists, LLC CurrentSince Aug 5, 2024 Accepting new patients
Winston Medical Clinic LLC PastSince Aug 5, 2024 Accepting new patients

Locations

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

120 Stone Creek Blvd
Ste 300
Flowood, MS 39232
Phone (769) 239-6141

1190 N State St
Ste 2A
Jackson, MS 39202
Phone (601) 292-4292

1896 Main St
Ste A
Madison, MS 39110
Phone (601) 398-9886

710 Highland Colony Pkwy
Ste A
Ridgeland, MS 39157
Phone (601) 398-9886

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1407573843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 VIEWPOINTE DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390566085",
            "telephone_number": "601-527-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 VIEWPOINTE DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390566085",
            "telephone_number": "601-527-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "IVEY",
        "middle_name": "BURT",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MS

Sources for this page

Verify at the official NPI Registry.