Shanda Jackson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R855819 Issued in MS

Practice address

6569 Highway 84
Ferriday, LA 71334-4573

Phone

(985) 892-7070

Fax

(855) 821-4499

NPI assigned

Sep 26, 2011

Last updated

Jun 30, 2022By 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 2

Addresses

Other identifiers 3

Other names 1

• Shanda Richardson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA, MS2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wound Care Associates LLCGroup PAC ID 0840314548, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Louisiana Homecare of Miss-Lou Home health agency, Ferriday, LA, CCN 197063
• Riverland Medical Center Hospital, Ferriday, LA, CCN 191318
• Franklin Medical Center Hospital, Winnsboro, LA, CCN 190140

Merit-based Incentive Payment System (MIPS)

Final score

69.56 of 100Reported as group

Quality

43.22

Promoting interoperability

88

Improvement activities

40

Cost

31.99

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wound Care Associates LLC

  dba MedCentris Specialty Group

  • Specialist
  • Hammond, LA
  • NPI 1568793750

  MS

  Medicare reassignment Care Compare group NPD

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

• Concordia Parish Hospital Service District Number One

  dba Trinity Medical

  • Critical Access Hospital
  • Ferriday, LA
  • NPI 1144227935
  Care Compare affiliation
• Franklin Parish Hospital Service Dist 1

  dba Franklin Medical Center

  • Rural Acute Care Hospital
  • Winnsboro, LA
  • NPI 1356399539
  Care Compare affiliation
• Louisiana Homecare of Miss-Lou, LLC

  • Home Health Agency
  • Jonesville, LA
  • NPI 1922046226
  Care Compare affiliation

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1578846598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1089",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704041089",
            "telephone_number": "985-892-7070",
            "fax_number": "985-892-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6569 HIGHWAY 84",
            "city": "FERRIDAY",
            "state": "LA",
            "postal_code": "713344573",
            "telephone_number": "985-892-7070",
            "fax_number": "855-821-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHANDA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06672",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R855819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09503346",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2319248",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION NUMBER",
            "identifier": "F0711469",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "credentialing@medcentris.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6569 Highway 84",
            "city": "Ferriday",
            "state": "LA",
            "country_code": "US",
            "postal_code": "713344573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANDA",
            "last_name": "RICHARDSON",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kara Shannon Hodge, RDN, LDN
• Ta Yu Huang, MD
• Casey Lynn Iverstine, D.D.S
• James Victor Iverstine, D.D.S.
• Kai'Daryia D Jackson, RSW
• Jim Iverstine, D.D.S., Apc
• Joseph Johnson
• Ashanta Rene Jones, FNP-C
• Ieshia Jones
• Keystone Medical Services of Ferriday, Inc.

• Family Nurse Practitioner in Ferriday, LA
• Providers in Ferriday, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.