Brett McCann Shirley, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

23935 Issued in TX

Practice address

4800 NE Stallings Dr Ste 113
Nacogdoches, TX 75965

Phone

(936) 305-5155

Fax

(936) 305-5322

NPI assigned

Mar 25, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial SurgeryAlso: Oral Surgery

Education

The Dental School at University of Texas HSC at San Antonio, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Oral and Maxillofacial Surgery InstituteGroup PAC ID 6002203767, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bshirley2@direct.wkhs.com

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.

• WK Oral and Maxillofacial Surgery Institute

  • Oral and Maxillofacial Surgery (Dentist)
  • Shreveport, LA
  • NPI 1104584515

  LA, Oral and Maxillofacial Surgery

  Medicare reassignment Care Compare group NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  LA

  Medicare reassignment NPD
• Brett Shirley DDS MD PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Nacogdoches, TX
  • NPI 1891264024

  Oral and Maxillofacial Surgery

  NPD Authorized official
• Anna Shirley, DDS, PLLC

  • Dental Clinic/Center
  • Nacogdoches, TX
  • NPI 1831660992
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• TH Healthcare, LTD

  • General Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1700885076

  Hospital

  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579

  Hospital

  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691

  Hospital

  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539

  Hospital

  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1467624973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 NE STALLINGS DR STE 113",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651250",
            "telephone_number": "936-305-5155",
            "fax_number": "936-305-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 NE STALLINGS DR STE 113",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75965",
            "telephone_number": "936-305-5155",
            "fax_number": "936-305-5322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "210-415-5830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4800 NE Stallings Dr Ste 113",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "75965",
            "country_code": "US",
            "telephone_number": "936-305-5155",
            "fax_number": "936-305-5322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "BRETT",
        "middle_name": "MCCANN",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "207796",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23935",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "Q0829",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "50203",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon L Smith MD PA
• Shannon L. Smith MD PA
• Apoorve Sharma
• Sheila Hill MD PA
• Anna Joy Windham Shirley, DDS
• Martha Morphis Sholars, LPC,LMFT, LCDC
• Leonard Keith Shotwell, D.C.
• Sidney J. Fowler, D.D.S.
• Michalla Silvey, CF-SLP
• Hadley Mahan Simmonds, LPC

• Oral and Maxillofacial Surgery (Dentist) in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.