Shellie J Moffett, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R855814 Issued in MS

Practice address

1105 Earl Frye Blvd
Amory, MS 38821-5500

Phone

(662) 256-7112

Fax

(662) 256-7116

NPI assigned

Oct 7, 2010

Last updated

Sep 27, 2019By 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 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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boa Vida Hospital of Aberdeen Ms LLCGroup PAC ID 0244505840, shared by 26 NPIs, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Monroe Regional Hospital Hospital, Aberdeen, MS, CCN 251302
• North Mississippi Medical Center-Gilmore Amory Hospital, Amory, MS, CCN 250025

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Critical Access Hospital
  • Aberdeen, MS
  • NPI 1285164046
  Medicare reassignment NPD
• Boa Vida Hospital of Aberdeen, Ms, LLC

  dba Monroe Regional Hospital

  • Multi-Specialty Clinic/Center
  • Aberdeen, MS
  • NPI 1710405741
  Medicare reassignment NPD
• Boa Vida Hospital of Aberdeen, Ms LLC

  dba MRH Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Aberdeen, MS
  • NPI 1134858269
  NPD
• Boa Vida Hospital of Aberdeen, Ms, LLC

  dba MRH Medical Group

  • Rural Health Clinic/Center
  • Aberdeen, MS
  • NPI 1245757301
  NPD (past)

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

• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Critical Access Hospital
  • Aberdeen, MS
  • NPI 1285164046
  Care Compare affiliation
• Monroe Health Services, Inc.

  dba North Mississippi Medical Center - Gilmore - Amory

  • General Acute Care Hospital
  • Amory, MS
  • NPI 1164993457
  Care Compare affiliation

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1902116064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10996 FOUR SEASONS PL",
            "address_2": "STE 100A",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078685",
            "telephone_number": "662-256-7112",
            "fax_number": "662-256-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 EARL FRYE BLVD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388215500",
            "telephone_number": "662-256-7112",
            "fax_number": "662-256-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFETT",
        "first_name": "SHELLIE",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R855814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Lynne Miller, MD
• Mississippi Em-I Medical Services, PC
• Mississippi Emergency Physician Services, LLC
• Mississippi State Department of Health
• Dennis Everett Mitchell, PHARMACIST
• Monroe Family Chiropractic, LLC
• Monroe Health Services, Inc. (North Mississippi Medical Center - Gilmore - Amory)
• Monroe Health Services, Inc. (Amory Cardiology Clinic)
• Monroe Health Services, Inc. (North Mississippi Medical Center - Gilmore - Amory)
• Monroe Health Services, Inc. (Amory Specialty Clinic)

• Family Nurse Practitioner in Amory, MS
• Providers in Amory, 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 Sep 27, 2019; 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.