Shannon D Dorris, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R863922 Issued in MS

Practice address

350 W Woodrow Wilson Ave
Jackson, MS 39213-7681

Phone

(601) 983-1385

NPI assigned

Nov 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS, KY2 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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  KY, MS

  Medicare reassignment NPD

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1447527486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 CRESCENT H DR",
            "city": "TERRY",
            "state": "MS",
            "postal_code": "391708745",
            "telephone_number": "601-983-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137681",
            "telephone_number": "601-983-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORRIS",
        "first_name": "SHANNON",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R863922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01953308",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nakeisha Donald
• Donald'S Home
• John Joel Donaldson, M.D. FAAP
• Door 2 Door
• Doris C. Bridges
• Patricia Ann Dotson, NP
• Mollie Doty, CFNP
• Ashley Doucet, M.D.
• Wesley Dillon Doug'Et
• Analise Douglas, M.D.

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.