Shaletha Martin, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

904818 Issued in MS

Practice address

11273 Highway 61 N
Robinsonville, MS 38664-9705

Phone

(662) 363-3224

Fax

(662) 363-3234

NPI assigned

Aug 13, 2021

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

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tunica County Healthcare AuthorityGroup PAC ID 6608898499, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10371/brand/1/csg/1/fhir/r4

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.

• Tunica County Healthcare Authority

  • Rural Health Clinic/Center
  • Tunica, MS
  • NPI 1245360148
  Medicare reassignment Care Compare group NPD
• Turnercare, LLC

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1548699283
  Medicare reassignment NPD
• Tunica County Healthcare Authority

  • Clinic/Center
  • Tunica, MS
  • NPI 1811618887
  NPD

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1659046399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 HENRY HILL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392042006",
            "telephone_number": "601-398-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11273 HIGHWAY 61 N",
            "city": "ROBINSONVILLE",
            "state": "MS",
            "postal_code": "386649705",
            "telephone_number": "662-363-3224",
            "fax_number": "662-363-3234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2135 Henry Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392042006",
            "country_code": "US",
            "telephone_number": "601-398-2335",
            "fax_number": "601-398-2741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHALETHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniella S Ellis, FNP
• Melanie Jo Hill, MSN, APRN, FNP-BC
• Leslie Yvette Horton
• Bobby Young Joe, M.D.
• Lapearls Residential and Private Care Facility
• Garnette Miller, DNP FNP BC
• Premise Health of Mississippi Medical PC

• Family Nurse Practitioner in Robinsonville, MS
• Providers in Robinsonville, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.