Shantay L Todd, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

905991 Issued in MS

Practice address

5112 Waldrup St
Memphis, TN 38116-8343

Phone

(901) 233-9301

NPI assigned

Oct 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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.

• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment Care Compare group NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  Family Medicine, MS

  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1467178327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 WALDRUP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381168343",
            "telephone_number": "901-233-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 WALDRUP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381168343",
            "telephone_number": "901-233-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "SHANTAY",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malyn Todd, MD
• Michael Sean Todd, LCSW
• Nakisha Nicole Todd
• Raleigh Dustin Todd, CRNA
• Rita Eileen Todd, PH.D.
• Tina M Todd, NP
• Lorraine A Todor, PHARMD
• Togetherness Personal Care
• Ebony La'Roya Tolbert
• Arianne Guan Toleno, DACM, L. AC.

• Family Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.