Shawanda Nechella Agnew, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24203 Issued in MS

Practice address

7736 Airways Blvd
Southaven, MS 38671-5306

Phone

(662) 772-5222

Fax

(662) 772-5957

NPI assigned

May 29, 2014

Last updated

Mar 22, 2024By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sagnew133252@direct.bmhcc.org
• Direct secure messaging: shawanda.agnew.1@23284.direct.athenahealth.com

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.

• Christ Community Health Services Inc

  dba Christ Community Health SVCS Inc

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1982686614
  Medicare reassignment NPD
• Christ Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1407017650
  NPD
• Christ Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, TN
  • NPI 1871299297
  NPD
• Lakeland Physician Practices LLC

  dba Lakeland Family Practice

  • Family Medicine Physician
  • Haleyville, AL
  • NPI 1679913784
  NPD (past)

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1790197416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3629 WILLIAMS BROOKE LN",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386326793",
            "telephone_number": "662-401-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7736 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715306",
            "telephone_number": "662-772-5222",
            "fax_number": "662-772-5957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8040 Wolf River Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "38138",
            "country_code": "US",
            "telephone_number": "901-725-8606",
            "fax_number": "901-759-9254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7736 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715306",
            "country_code": "US",
            "telephone_number": "662-772-5222",
            "fax_number": "662-772-5957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGNEW",
        "first_name": "SHAWANDA",
        "middle_name": "NECHELLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "61110",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "L.4005R",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "24203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ageless Men's Health, LLC
• Agilitas USA Inc (Results Physiotherapy)
• Agilitas USA Inc. (Results Physiotherapy)
• Agilitas USA, Inc (Results Physiotherapy)
• Agilitas USA, Inc (Results Physiotherapy)
• Shuaib Ahmad, MD
• Shahzeb Hassan Ahmed, MD
• Ahp of Mississippi, Inc.
• Ahp of Southaven, Inc
• Babatunde Abdulsalam Akande

• Family Medicine Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.