Amy Monett-Shamon Shoulders Thomas, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Bolton, MS
NPI 1831453091 · NPPES record last updated Sep 5, 2021
Key facts
- NPI
- 1831453091
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F0312107 (MS)
- Practice address
- 115 W Madison St
Bolton, MS 39041-3209 - Phone
- (601) 866-7723
- Fax
- (601) 866-7773
- NPI assigned
- Jul 2, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|---|
| I20130821000818 | MS | Practitioner - Nurse Practitioner | 3577705631 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F0312107 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Health Network LLC | Current |
Accepting new patients | |
| Signify Health, LLC | Current |
Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
232 Market St
Jackson, MS 39232
Phone (588) 498-6767
460 Briarwood Dr
Ste 400
Jackson, MS 39206
Phone (601) 203-1016
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F0312107 | MS | Yes |
Addresses
Primary practice location
115 W Madison St
Bolton, MS 39041-3209
Mailing address
115 W Madison St
Bolton, MS 39041-3209
Phone (601) 866-7723
Other names
- Mrs. Amy Monet-Shamon Thomas
Other providers in Bolton, MS
- Lisa Byrd Healthcare Inc
- Lisa Byrd Healthcare Inc
- Jean Pennington Marks
- Mississippi Nurse Practitioners Inc
- Fredrica Oliver
- Alisha White
All providers in Bolton, 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 Sep 5, 2021. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.