Beautiful Minds Mental Health Services

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BEAUTIFUL MINDS MENTAL HEALTH SERVICES

Practice address

11100 Old Hwy 64
Bolivar, TN 38008

Phone

(901) 300-6808

NPI assigned

Jun 11, 2022

Last updated

Sep 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shanna Shackelford, DNPNPI 1720639172

Title

Aprn, Pmhnp

Phone

(901) 300-6808

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shanna Shackelford, DNP-APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Bolivar, TN
  • NPI 1720639172
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1770213928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25013",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258001",
            "telephone_number": "901-300-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 OLD HWY 64",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "38008",
            "telephone_number": "901-300-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFUL MINDS MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-11",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_title_or_position": "APRN, PMHNP",
        "authorized_official_telephone_number": "901-300-6808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodrick Anderson, OTR/L
• Freeman Hunter Baird Jr., BS
• Amanda B Baker, PHARMD
• Janell Joan Batchellor, M.D.
• Tynetta Qunique Beamon-Simpson, APRN
• Maggie G. Billings, FNP, BC
• Hannah Black, DPT
• John Lee Blankenship, M.D.
• Louis E Bogard, DDS
• Bolivar Assisted Care Living, LLC

• Psychiatric/Mental Health Nurse Practitioner in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare 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.