Individual provider Active NPI

Sheree Conley-Donaldson, PHD, DNP, FNP, PMHNP

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1649666744
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R893659 Issued in MS
Practice address
100 S 20TH Ave Ste a
Hattiesburg, MS 39401-6043
Phone
(769) 250-8054
NPI assigned
Apr 15, 2015
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R893659 MS
Family Nurse Practitioner 363LF0000X R893659 MS Primary

Addresses

Primary practice location

100 S 20TH Ave Ste a
Hattiesburg, MS 39401-6043

Mailing address

185 Millpond Drive
Hattiesburg, MS 39401-5559
Phone (601) 602-3161

Other practice location 1

1101 Old Highway 11
Ellisville, MS 39437
Phone (601) 477-9384

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
I20150520001251 MS Practitioner - Nurse Practitioner 5193045870 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orange Grove Urgent CareGroup PAC ID 6103978721, 11 clinicians
Picayune Urgent Care Clinic, LLCGroup PAC ID 3072612175, 10 clinicians
Hattiesburg Urgent Care LLCGroup PAC ID 4981913308, 19 clinicians

Practice addresses (Care Compare)

10556 Hwy 49
Gulfport, MS 39503-4109
Phone (228) 539-2399

422 Memorial Blvd
Picayune, MS 39466-5544
Phone (601) 798-2151

6101 U S Hwy 49
Hattiesburg, MS 39401-7158

6101 U S Hwy 49
Hattiesburg, MS 39402-7158
Phone (228) 223-1927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
R893659MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center Inc CurrentSince May 26, 2015 Accepting new patients
Gulfport 49 Imaging, LLC CurrentSince Feb 10, 2024 Accepting new patients
Hattiesburg Urgent Care, LLC CurrentSince Mar 23, 2023 Accepting new patients
Maxem Health Urgent Care Flowood CurrentSince Mar 24, 2023 Accepting new patients
Maxem Health Urgent Care McComb CurrentSince Mar 23, 2023 Accepting new patients
Maxem Health Urgent Care Magee CurrentSince Mar 18, 2026 Accepting new patients
Family Health Center, Inc CurrentSince May 26, 2015 Accepting new patients
Picayune Urgent Care Clinic, LLC CurrentSince Nov 18, 2023 Accepting new patients
Orange Grove Urgent Care CurrentSince Feb 10, 2024 Accepting new patients
Ocean Springs Urgent Care CurrentSince Feb 10, 2024 Accepting new patients
Petal Urgent Care LLC CurrentSince Nov 18, 2023 Accepting new patients

Locations

10556 Highway 49
Gulfport, MS 39503
Phone (228) 539-2399

6101 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 909-6240

117 S 11th Ave
Laurel, MS 39440
Phone (601) 425-3033

1529 Simpson Highway 49
Magee, MS 39111
Phone (601) 439-7288

101 Edgewood Dr
McComb, MS 39648
Phone (601) 324-3244

1514 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 382-9222

1272 Evelyn Gandy Pkwy
Ste 60
Petal, MS 39465
Phone (601) 336-5393

422 Memorial Blvd
Picayune, MS 39466
Phone (601) 749-0080

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1649666744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 MILLPOND DRIVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394015559",
            "telephone_number": "601-602-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S 20TH AVE STE A",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394016043",
            "telephone_number": "769-250-8054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Old Highway 11",
            "address_purpose": "LOCATION",
            "city": "Ellisville",
            "state": "MS",
            "postal_code": "39437",
            "country_code": "US",
            "telephone_number": "601-477-9384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONLEY-DONALDSON",
        "first_name": "SHEREE",
        "name_prefix": "Dr.",
        "credential": "PHD, DNP, FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R893659",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R893659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.