Individual provider Active NPI

Sheila Burns

  • Occupational Therapist
  • Kosciusko, MS
National Provider Identifier
1487947818
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT0137 Issued in MS
Practice address
340 Highway 12 W
Kosciusko, MS 39090-3209
Phone
(662) 289-3588
Fax
(662) 289-3533
NPI assigned
May 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT0137 MS Primary

Addresses

Primary practice location

340 Highway 12 W
Kosciusko, MS 39090-3209

Mailing address

PO Box 23996
Jackson, MS 39225-3996
Phone (601) 206-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204001033 MS Practitioner - Occupational Therapist in Private Practice 4385174531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Medical Group of Mississippi LLCGroup PAC ID 8729973623, 31 clinicians

Practice addresses (Care Compare)

340 Hwy 12 W
Kosciusko, MS 39090-3209
Phone (662) 289-3588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT0137MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group of Mississippi LLC CurrentSince Jan 30, 2025 Accepting new patients
Premier Medical Group of Mississippi LLC PastSince Jan 19, 2025 Accepting new patients

Locations

332 Highway 12 W
Kosciusko, MS 39090
Phone (601) 206-6100

340 Highway 12 W
Kosciusko, MS 39090
Phone (662) 289-1551

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1487947818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23996",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253996",
            "telephone_number": "601-206-6100",
            "fax_number": "601-206-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 HIGHWAY 12 W",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903209",
            "telephone_number": "662-289-3588",
            "fax_number": "662-289-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "SHEILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT0137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kosciusko, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.