Shelby Davis, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R883040 Issued in MS

Practice address

2860 McDowell Road Ext
Jackson, MS 39204-4238

Phone

(601) 372-1117

Fax

(601) 373-3004

NPI assigned

Nov 24, 2015

Sex

Female

Sole proprietor

No

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

University of Mississippi School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Systems Management, LLCGroup PAC ID 5092964643, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Medical Systems Management LLC

  dba Rankin Rural Medical Clinic

  • Rural Health Clinic/Center
  • Richland, MS
  • NPI 1740555267
  Medicare reassignment Care Compare group NPD
• Minor Med Care, LLC

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1407968738
  Medicare reassignment NPD
• Minor Med Care, LLC

  • Rural Health Clinic/Center
  • Raymond, MS
  • NPI 1669575627
  NPD

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1568836815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MCDOWELL ROAD EXT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392044238",
            "telephone_number": "601-372-1117",
            "fax_number": "601-373-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 MCDOWELL ROAD EXT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392044238",
            "telephone_number": "601-372-1117",
            "fax_number": "601-373-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHELBY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R883040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda O Davis
• Ronald D Davis, M.D.
• Sandra Stewart Davis, RD
• Serrenthia Davis, PCMHT
• Sharon R Davis, FPMHNP
• Stacey Davis
• Stanitia W. Davis, D.P.M.
• Sylvia Davis
• Tammy Sims Davis, PA-C
• Tearsanee Carlisle Davis, DNP, FNP-BC

• Adult Health Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Adult Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.