Shelby H Jackson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903610 Issued in MS

Practice address

960 Avent Dr
Grenada, MS 38901-5230

Phone

(662) 227-7000

NPI assigned

Feb 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shelby Helen Phelon-Jackson Professional name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of Mississippi - University of Mississippi Medical CenterGroup PAC ID 1850293036, 956 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168

Merit-based Incentive Payment System (MIPS)

Final score

83.94 of 100Reported as group

Quality

67.75

Promoting interoperability

100

Improvement activities

40

Cost

71.17

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sphelon53801@ummc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment Care Compare group NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• State of Mississippi-University of Mississippi Medical Center

  • Family Medicine Physician
  • Grenada, MS
  • NPI 1932538527
  NPD
• Grenada Lake Medical Center

  • Obstetrics & Gynecology Physician
  • Grenada, MS
  • NPI 1669578894
  NPD (past)
• University Physicians, PLLC

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1609984574
  NPD (past)

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

• State of Mississippi-University of Mississippi Medical Center

  • Psychiatric Hospital
  • Grenada, MS
  • NPI 1083041917
  Care Compare affiliation
• State of Mississippi-University of Mississippi Medical Center

  • General Acute Care Hospital
  • Grenada, MS
  • NPI 1558798603
  Care Compare affiliation

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1841822152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DRIVE",
            "address_2": "CBO-SUITE 4300",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39056",
            "telephone_number": "601-496-9794",
            "fax_number": "601-815-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 AVENT DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389015230",
            "telephone_number": "662-227-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHELBY",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "PHELON-JACKSON",
            "middle_name": "HELEN",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Thomas Holden, MD
• Precious Holmes
• Hayden McKay Horan, DMD
• Deborah Hughes, FNP-C
• Tatayana Hughes, LMSW, CMHT
• James W. Fite, MD
• John a Marascalco, MD, PA
• John H. Coleman,PLLC
• Nekesha Micole Johnson, FNP-BC
• Luanne Fair Pender Jones, PHARM. D.

• Family Nurse Practitioner in Grenada, MS
• Providers in Grenada, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.