NPIMap

Individual provider Active NPI

Misty L Shatley, P.A.-C

  • Medical Physician Assistant
  • West Memphis, AR
National Provider Identifier
1790732493
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA234 Issued in 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
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA234 AR Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081217000010 AR Practitioner - Physician Assistant 8224024781 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
T W Wagner IncGroup PAC ID 1153359096, 9 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
T W Wagner Inc CurrentSince Sep 2, 2025 Accepting new patients
St Bernards Hospital Inc CurrentSince Apr 27, 2015 Accepting new patients
St Bernards Hospital Inc. CurrentSince Apr 27, 2015 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
T W Wagner Inc CurrentSince Sep 2, 2025 Accepting new patients
Five Rivers Medical Center Inc Current Accepting new patients
Caddoes Emergency Physicians LLC Physician Assistant Past Accepting new patients
Chiro Care Inc Past Accepting new patients
Tennessee Emergency Physicians, PLLC PastSince Feb 9, 2020 Accepting new patients
International Spine Surgery & Pain Institure PA Past Accepting new patients
1St Choice Healthcare Inc PastSince Jan 1, 1990 Accepting new patients

Locations

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630

225 E Washington 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

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: mshatley@frmc.medalliesdirect.net
  • Direct secure messaging: mshatley@sbpc.medalliesdirect.net

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1790732493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N 7TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012001",
            "telephone_number": "870-735-3842",
            "fax_number": "360-462-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 7TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012001",
            "telephone_number": "870-735-3842",
            "fax_number": "360-462-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATLEY",
        "first_name": "MISTY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

Verify at the official NPI Registry.