Misty L Shatley, P.A.-C
Individual provider Active NPI Medical Physician Assistant · West Memphis, AR
NPI 1790732493 · NPPES record last updated Aug 11, 2026
Key facts
- NPI
- 1790732493
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA234 (AR)
- Practice address
- 900 N 7TH St
West Memphis, AR 72301-2001 - Phone
- (870) 735-3842
- Fax
- (360) 462-6952
- NPI assigned
- May 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- T W Wagner Inc
Practice addresses (Care Compare)
3644 W Hwy 18
Manila, AR 72442
Phone (870) 561-3300
730 Greenwood Ave
Lepanto, AR 72354-3215
Phone (870) 475-3825
PO Box
Manila, AR 72442
Hospital & facility affiliations
- St Bernards Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- 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 |
|---|---|---|---|---|
| I20081217000010 | AR | Practitioner - Physician Assistant | 8224024781 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Five Rivers Medical Center Inc | Current | Accepting new patients | |
| T W Wagner Inc | Current |
Accepting new patients | |
| St Bernards Physician Clinics Inc | Current | Accepting new patients | |
| T W Wagner Inc | Current |
Accepting new patients | |
| St Bernards Hospital Inc | Current |
Accepting new patients | |
| St Bernards Hospital Inc. | Current |
Accepting new patients | |
| 1St Choice Healthcare Inc | Past |
Accepting new patients | |
| Caddoes Emergency Physicians LLC | Physician Assistant | Past | Accepting new patients |
| 1St Choice Healthcare Inc | Past |
Accepting new patients | |
| Chiro Care Inc | Past | Accepting new patients | |
| International Spine Surgery & Pain Institure PA | Past | Accepting new patients | |
| Tennessee Emergency Physicians, PLLC | Past |
Accepting new patients |
Locations
1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440
225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630
225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630
730 Greenwood Ave
#B
Lepanto, AR 72354
Phone (870) 475-3825
3644 W State Highway 18
Manila, AR 72442
Phone (870) 561-1500
2801 Medical Center Dr
Pocahontas, AR 72455
Phone (870) 892-6000
Interoperability endpoints
- mshatley@sbpc.medalliesdirect.net
- mshatley@frmc.medalliesdirect.net
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA234 | AR | Yes |
Addresses
Primary practice location
900 N 7TH St
West Memphis, AR 72301-2001
Mailing address
900 N 7TH St
West Memphis, AR 72301-2001
Phone (870) 735-3842
Other providers in West Memphis, AR
- Sfmpe - Crittenden, LLC
- Yousef Shaddood
- Ayesha Saeed Shah
- Sharinglyfe Living Program
- Heather Sharpe
- Constance Shaw
- Angela J Sheddan
- Alexus Shell
- Sheltered Wkshp of Crittenden Co Inc
- Patricia Shelton
All providers in West Memphis, AR · Medical Physician Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2026. 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.