Shari Chism Medley, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024180189 Issued in VA

Practice address

1088 Bagwell Dr
Scottsburg, VA 24589-2709

Phone

(434) 476-5131

Fax

(434) 476-5132

NPI assigned

Oct 7, 2020

Last updated

Oct 7, 2020By the provider in NPPES

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

Other names 1

• Shari Chism Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Pathways Youth Services

  dba Peaceful Pathways

  • Mental Illness Community Based Residential Treatment Facility
  • Scottsburg, VA
  • NPI 1306713714
  NPD Authorized official
• Wrapping Arms Youth Services LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Scottsburg, VA
  • NPI 1013891803
  NPD Authorized official

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1699372060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 SALISHAN DR",
            "city": "HALIFAX",
            "state": "VA",
            "postal_code": "245583303",
            "telephone_number": "434-572-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 BAGWELL DR",
            "city": "SCOTTSBURG",
            "state": "VA",
            "postal_code": "245892709",
            "telephone_number": "434-476-5131",
            "fax_number": "434-476-5132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "SHARI",
        "middle_name": "CHISM",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024180189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARI",
            "last_name": "CHISM",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Juanita M Carden
• Marable Medical Transportation
• Pathways Youth Services (Peaceful Pathways)
• Pathways Youth Services, LLC
• Pathways Youth Services, LLC
• Mark Romack, OTR
• Michael Stephens Rose Jr., LPC

• Psychiatric/Mental Health Nurse Practitioner in Scottsburg, VA
• Providers in Scottsburg, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.