Shawna Lee Martin, AGPCNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

901782 Issued in MS

Practice address

10084 Oak Run Dr S
Olive Branch, MS 38654-4836

Phone

(901) 517-8641

NPI assigned

Oct 5, 2016

Last updated

Oct 5, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Comprehensive Rehab Consultants PLLC

  dba Comprehensive Rehab Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  MS, Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Pain Management Centers of America, PSC

  • Interventional Pain Medicine Physician
  • Evansville, IN
  • NPI 1992271811

  TN

  Medicare reassignment NPD
• Pain Management Centers of America, PSC

  • Interventional Pain Medicine Physician
  • Evansville, IN
  • NPI 1205300852
  NPD (past)

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1861942682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10084 OAK RUN DR S",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386544836",
            "telephone_number": "901-517-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10084 OAK RUN DR S",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386544836",
            "telephone_number": "901-517-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHAWNA",
        "middle_name": "LEE",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "901782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margo D Ray Inc
• Christopher Scott Markham, LPT
• Carla Arnette Martin, D.P.M.
• Madelon Sullivan Martin, LPC, RPT
• Nicole L Martin, LPC
• Briana Cymone Mason, PHARMD
• Masterpiece Counseling and Health Services, LLC
• Erica Mathis, DDS
• Stacey Leigh Mathis, MS,CCC-SLP
• Russell Howard Mauk, DC

• Nurse Practitioner in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.