Wirt Fletcher Shrock Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10738 Issued in MS

Practice address

630 Northwest Ave
Durant, MS 39063-3337

Phone

(662) 653-3012

Fax

(662) 653-6423

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

Yes

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

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

Family Practice

Education

University of Mississippi School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
• Accentcare Home Health of Carthage Home health agency, Carthage, MS, CCN 257129
• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• Holmes County Hospital and Clinics Hospital, Lexington, MS, CCN 251319
• Baptist Medical Center Attala Hospital, Kosciusko, MS, CCN 251336

Merit-based Incentive Payment System (MIPS)

Final score

83.94 of 100Reported as group

Quality

67.75

Promoting interoperability

100

Improvement activities

40

Cost

71.17

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Rodgers Medical Clinic

  • Primary Care Clinic/Center
  • Durant, MS
  • NPI 1033095617
  NPD (past)

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

• BMC - Attala, LLC

  • Critical Access Hospital
  • Kosciusko, MS
  • NPI 1730566027

  Hospital

  Care Compare affiliation
• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585

  Hospital

  Care Compare affiliation
• Sta-Home Health Agency of Carthage, Inc

  • Home Health Agency
  • Carthage, MS
  • NPI 1275674533
  Care Compare affiliation
• Sta-Home Health Agency of Jackson, Inc.

  • Home Health Agency
  • Clinton, MS
  • NPI 1356482749
  Care Compare affiliation
• State of Mississippi - University of Mississippi Medical Center

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266192000000",
    "number": "1497843676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 NORTHWEST AVE",
            "city": "DURANT",
            "state": "MS",
            "postal_code": "390633337",
            "telephone_number": "662-653-3012",
            "fax_number": "662-653-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 NORTHWEST AVE",
            "city": "DURANT",
            "state": "MS",
            "postal_code": "390633337",
            "telephone_number": "662-653-3012",
            "fax_number": "662-653-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROCK",
        "first_name": "WIRT",
        "middle_name": "FLETCHER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011270",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daryl Roby, DMD
• Rodgers Medical Clinic
• Phillip Eric Rodgers, FNP-C
• S&M Medical Clinic
• Shannon Pritchard
• Marilyn Smith, PMHNP
• Henrietta Stewart
• Michael Stewart
• Tender Care LLC
• Jabari Rashard Terrell, FNP-BC

• All providers in Durant, MS
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; 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.