Individual provider Active NPI

Deanna N Shelton, A.P.N.

  • Family Nurse Practitioner
  • Olive Branch, MS
National Provider Identifier
1427375716
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14942 Issued in TN
Practice address
4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone
(662) 932-9111
NPI assigned
Apr 26, 2010
Last updated
May 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 14942 TN Primary
Family Nurse Practitioner 363LF0000X 810514 MS

Addresses

Primary practice location

4250 Bethel Rd
Olive Branch, MS 38654-8737

Mailing address

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (662) 932-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131031000268 MS Practitioner - Nurse Practitioner 9537283155 Reassigns benefits to 1 organization
I20180925003153 TN Practitioner - Nurse Practitioner 9537283155 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14942TNMDPhysical Therapist
810514MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Radar EMS, LLC CurrentSince Oct 1, 2023 Accepting new patients
Southeastern Emergency Physicians LLC CurrentSince Aug 12, 2023 Accepting new patients
Carr PLLC CurrentSince May 13, 2016 Accepting new patients
Radar Transport LLC CurrentSince Oct 1, 2023 Accepting new patients
T M Carr MD PC CurrentSince Sep 1, 2020 Accepting new patients
North Internal Medicine, P. C. PastSince Nov 9, 2020 Accepting new patients
Mid-South Ear, Nose, and Throat, P.C. PastSince Apr 17, 2017 Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

2670 Union Avenue Ext
Ste 915
Memphis, TN 38112
Phone (901) 352-0062

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

Interoperability endpoints

  • Direct secure messaging: dshelton@landmarkhealth-direct.org
  • FHIR API: https://api.platform.athenahealth.com/21348/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1427375716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 BETHEL RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548737",
            "telephone_number": "662-932-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BETHEL RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548737",
            "telephone_number": "662-932-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "DEANNA",
        "middle_name": "N",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "14942",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "810514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.