Individual provider Active NPI

Shanterrica Shanae' Pegues, MSW, CMHT

  • Social Worker
  • Oxford, MS
National Provider Identifier
1417733064
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
152 Highway 7 S
Oxford, MS 38655-5392
Phone
(662) 234-7521
NPI assigned
Sep 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

152 Highway 7 S
Oxford, MS 38655-5392

Mailing address

13A County Road 298
Abbeville, MS 38601-9107
Phone (662) 783-2703

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828004704 MS Practitioner - Mental Health Counselor 9537608062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

152 Hwy 7 S
Communicare
Oxford, MS 38655-5392
Phone 662234752136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Commission on Mental Illness/Mental Retardation CurrentSince Aug 20, 2024 Accepting new patients
North Mississippi Commission on Mental Illness/Mental Retardation CurrentSince Aug 20, 2024 Accepting new patients

Locations

152 Highway 7 S
Oxford, MS 38655
Phone (662) 234-7237

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1417733064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13A COUNTY ROAD 298",
            "city": "ABBEVILLE",
            "state": "MS",
            "postal_code": "386019107",
            "telephone_number": "662-783-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 HIGHWAY 7 S",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555392",
            "telephone_number": "662-234-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGUES",
        "first_name": "SHANTERRICA",
        "middle_name": "SHANAE'",
        "name_prefix": "Ms.",
        "credential": "MSW, CMHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.