Shelley S Leach, FNP
Individual provider Active NPI Family Nurse Practitioner · Mendenhall, MS
NPI 1760615595 · NPPES record last updated Aug 6, 2025
Key facts
- NPI
- 1760615595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R863242 (MS)
- Practice address
- 820 Mangum Ave
Mendenhall, MS 39114 - Phone
- (601) 847-5111
- Fax
- (601) 847-3060
- NPI assigned
- Aug 27, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Exceed Physical Therapy, LLC
Practice addresses (Care Compare)
12261 Hwy 49
Suite 1
Gulfport, MS 39503-2976
Phone (228) 265-7185
820 Mangum Ave
Mendenhall, MS 39114-3025
Phone (601) 847-5111
Hospital & facility affiliations
- Centerwell Home Health
- Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson
- Simpson General Hospital Cah
- Magee General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151026002702 | MS | Practitioner - Nurse Practitioner | 1557670940 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simpson Community Healthcare Inc. | Current |
Accepting new patients | |
| Simpson Community Healthcare, Inc | Current |
Accepting new patients | |
| 121 Medical Place, Inc | Current |
Accepting new patients | |
| Simpson Community Healthcare, Inc. | Current | Accepting new patients | |
| Amnuey M Chiemprabha MD PA | Past |
Accepting new patients |
Locations
820 Mangum Ave
Mendenhall, MS 39114
Phone (601) 847-5066
820 Mangum Ave
#121
Mendenhall, MS 39114
Phone (601) 847-5111
1842 Simpson Highway 149
Mendenhall, MS 39114
Phone (601) 847-2221
1827C Simpson Highway 149
Mendenhall, MS 39114
Phone (601) 847-2424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R863242 | MS | Yes |
Addresses
Primary practice location
820 Mangum Ave
Mendenhall, MS 39114
Mailing address
820 Mangum Ave
Mendenhall, MS 39114
Phone (601) 847-5111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00476391 | Medicaid | MS |
Other providers in Mendenhall, MS
- Bobbie Hughes
- Amy Jenkins
- Penelope Jones
- Kimberly Blair Smith DMD PA
- Nakecia Dungan Kinabrew
- Peyton Lovelace
- Leanna Maddox
- Shenika Magee
- Maison de Jorice LLC. Dba/ Allure Health
- McGuffee Drugs Inc
All providers in Mendenhall, MS · Family 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 Aug 6, 2025. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.