Individual provider Active NPI

Shannon Haney Loftin, FNP-C

  • Family Nurse Practitioner
  • Columbia, MS
National Provider Identifier
1609226109
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901706 Issued in MS
Practice address
502 Broad St
Columbia, MS 39429-3037
Phone
(601) 736-8282
Fax
(601) 736-8333
NPI assigned
Jun 15, 2016
Last updated
Dec 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 901706 MS
Family Nurse Practitioner 363LF0000X 901706 MS Primary

Addresses

Primary practice location

502 Broad St
Columbia, MS 39429-3037

Mailing address

1065 E Broad St
Monticello, MS 39654-7703
Phone (601) 587-4051

Other identifiers 1

IdentifierTypeStateIssuer
01808562MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sloftin53740@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160920000440 MS Practitioner - Nurse Practitioner 8921395963 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RH Hospitalist Medicine of Walthall General LLCGroup PAC ID 2365881091, 16 clinicians
Southwest Mississippi Regional Medical CenterGroup PAC ID 5193633907, shared by 11 NPIs, 82 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Tylertown, MS 39667-2022
Phone (601) 876-2122

1065 E Broad St
Lawrence County Hospitalists
Monticello, MS 39654-7703
Phone (601) 587-4051

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
901706MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RH Hospitalist Medicine of Walthall General LLC CurrentSince Nov 1, 2024 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Jan 1, 2023 Accepting new patients
RH Hospitalist Medicine of Jefferson Davis LLC CurrentSince Nov 1, 2024 Accepting new patients
Keystone Medical Services of Ms, Inc CurrentSince Jul 31, 2023 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Jan 1, 2023 Accepting new patients
RH Emergency Medicine of Pearl River LLC CurrentSince Nov 1, 2024 Accepting new patients
RH Emergency Medicine of Walthall General LLC CurrentSince Nov 1, 2024 Accepting new patients
RH Emergency Medicine of Jefferson Davis LLC CurrentSince Nov 1, 2024 Accepting new patients
RH Emergency Medicine of Perry County LLC CurrentSince Nov 1, 2024 Accepting new patients
RH Emergency Medicine of Marion General LLC CurrentSince Jun 1, 2025 Accepting new patients
Southwest Mississippi Regional Medical Center Current Accepting new patients

Locations

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

1065 E Broad St
Monticello, MS 39654
Phone (601) 249-1350

1167 E Broad St
Monticello, MS 39654
Phone (601) 587-1433

305 W Moody St
Poplarville, MS 39470
Phone (601) 795-4345

1102 Rose St
Prentiss, MS 39474
Phone (601) 792-2947

206 Bay Ave
Richton, MS 39476
Phone (601) 788-6316

100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455

Interoperability endpoints

  • Direct secure messaging: sloftin53740@directpatientrecord.com

Organizations & group practices 11

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1609226109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 E BROAD ST",
            "city": "MONTICELLO",
            "state": "MS",
            "postal_code": "396547703",
            "telephone_number": "601-587-4051",
            "fax_number": "601-587-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 BROAD ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293037",
            "telephone_number": "601-736-8282",
            "fax_number": "601-736-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFTIN",
        "first_name": "SHANNON",
        "middle_name": "HANEY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "901706",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01808562",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sloftin53740@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "502 Broad St",
            "city": "Columbia",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394293037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MS

Sources for this page

Verify at the official NPI Registry.