Shatessie Marie Ford, CRT

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

200003542 Issued in MS

Practice address

211 E Main St
Okolona, MS 38860-1529

Phone

(662) 322-0340

NPI assigned

Aug 21, 2014

Last updated

Oct 8, 2014By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1487053740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S GATLIN ST",
            "city": "OKOLONA",
            "state": "MS",
            "postal_code": "388602005",
            "telephone_number": "662-322-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E MAIN ST",
            "city": "OKOLONA",
            "state": "MS",
            "postal_code": "388601529",
            "telephone_number": "662-322-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "SHATESSIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CRT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "200003542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Vester Calvert Jr., FNP-C
• Sarah Carollo
• Joy S Chapman, NP
• Chickasaw FMC
• Family Medical Clinic of Okolona
• Harley's Home Care
• Heavenly Angels Community Living, Inc.
• Whitley Breanna Hill, EN
• Hodges Adult Day Care Service Inc
• Hometown Care of North Mississippi, Inc

• Durable Medical Equipment & Medical Supplies in Okolona, MS
• Providers in Okolona, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.