Individual provider Active NPI

Shirley S Donelson, M.D.

  • Gastroenterology Physician
  • Flowood, MS
National Provider Identifier
1669543120
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
15892 Issued in MS
Practice address
2510 Lakeland Dr
Flowood, MS 39232-9513
Phone
(606) 355-1234
Fax
(601) 326-3559
NPI assigned
Nov 13, 2006
Last updated
Nov 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 15892 MS Primary

Addresses

Primary practice location

2510 Lakeland Dr
Flowood, MS 39232-9513

Mailing address

2510 Lakeland Dr
Flowood, MS 39232-9513
Phone (606) 355-1234

Other identifiers 1

IdentifierTypeStateIssuer
00119509MedicaidMS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110118000467 MS Practitioner - GastroenterologyPractitioner - Internal Medicine 6901095215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
76.9 of 100Reported as group
Quality
47.44
Promoting interoperability
98
Improvement activities
40
Cost
77.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15892MSMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Associates, P.a. Gastroenterology Current Accepting new patients
Gastrointestinal Associates, PA CurrentSince Jun 18, 2015 Accepting new patients
Gastrointestinal Associates, P.a. Gastroenterology CurrentSince Jun 18, 2015 Accepting new patients
University Internal Medicine Assoc LLP Past Accepting new patients

Locations

2510 Lakeland Dr
Flowood, MS 39232
Phone (601) 355-1234

1421 N State St
Ste 203
Jackson, MS 39202
Phone (601) 355-1234

106 Highland Way
Ste 101
Madison, MS 39110
Phone (601) 355-1234

106 Highland Way
Ste 202
Madison, MS 39110
Phone (601) 200-3376

Interoperability endpoints

  • Direct secure messaging: giasdonelson@directaddress.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1669543120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329513",
            "telephone_number": "606-355-1234",
            "fax_number": "601-326-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329513",
            "telephone_number": "606-355-1234",
            "fax_number": "601-326-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONELSON",
        "first_name": "SHIRLEY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MS",
            "license": "15892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119509",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

Verify at the official NPI Registry.