SHC Medical Partners of Mississippi, LLC

Key facts

NPI: 1720837396
Entity type: Organization (NPI type 2)
Primary specialty: Nurse Practitioner 363L00000X
Legal business name: SHC MEDICAL PARTNERS OF MISSISSIPPI, LLC
Practice address: 1000 Highland Colony Pkwy
Ridgeland, MS 39157-2073
Phone: (501) 267-9870
NPI assigned: May 16, 2024
Organization subpart: No

Authorized official

Name: Sarah Altstadt
Title: Provider Enrollment Specialist
Phone: (502) 630-7494

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Walgreen Co Pharmacy · Menomonie, WI · NPI 1962417048

NPD member Member Of

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Stephanie L Green, CFNP Family Nurse Practitioner · Picayune, MS · NPI 1376504357

Medicare reassignment NPD MS · NURSE PRACTITIONER
Teresa Sellers, FNP Family Nurse Practitioner · Hattiesburg, MS · NPI 1619440534

Medicare reassignment NPD MS · NURSE PRACTITIONER
Brenda Thrash, FNP Family Nurse Practitioner · Philadelphia, MS · NPI 1881909125

Medicare reassignment NPD MS
Crystal Parker McNabb, FNP-C Family Nurse Practitioner · Hattiesburg, MS · NPI 1326565763

Medicare reassignment MS

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MS

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20240711000498	MS	Part B Supplier - Clinic/Group Practice	5991240202	Receives reassigned benefits from 4 practitioners Practice locations: Ridgeland, MS

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nurse Practitioner Group: 193200000X MULTI-SPECIALTY GROUP	363L00000X			Yes

Addresses

Primary practice location

1000 Highland Colony Pkwy
Ridgeland, MS 39157-2073

Mailing address

805 N Whittington Pkwy
Louisville, KY 40222-7101

Other providers in Ridgeland, MS

All providers in Ridgeland, MS · Nurse Practitioner in Mississippi

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.