Shelby B Polk, DNP, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R852951 Issued in MS

Practice address

1040 River Oaks Dr Ste 302
Flowood, MS 39232-9575

Phone

(601) 939-9923

Fax

(601) 939-9924

NPI assigned

Aug 25, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Delta Health System

  • Community/Retail Pharmacy
  • Greenville, MS
  • NPI 1376930149
  NPD (past)
• Delta Medical Group

  • Emergency Medicine Physician
  • Greenville, MS
  • NPI 1790701134
  NPD (past)
• Delta Physician Practices

  • Family Nurse Practitioner
  • Greenville, MS
  • NPI 1598086639
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1912014648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 COLLEGE ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387323113",
            "telephone_number": "662-207-4913",
            "fax_number": "662-939-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR STE 302",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329575",
            "telephone_number": "601-939-9923",
            "fax_number": "601-939-9924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2335 Highway 1 S",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "MS",
            "postal_code": "387018337",
            "country_code": "US",
            "telephone_number": "601-398-9698",
            "fax_number": "601-398-9698",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 E Baker St",
            "address_purpose": "LOCATION",
            "city": "Indianola",
            "state": "MS",
            "postal_code": "387512451",
            "country_code": "US",
            "telephone_number": "601-340-5657",
            "fax_number": "601-340-5657",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "580 Friars Point Rd",
            "address_purpose": "LOCATION",
            "city": "Clarksdale",
            "state": "MS",
            "postal_code": "386149734",
            "country_code": "US",
            "telephone_number": "601-566-1224",
            "fax_number": "601-566-1224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLK",
        "first_name": "SHELBY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R852951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08476778",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Plastic & Hand Surgery Associates PLLC
• Plastic Surgery Associates of Ms
• Plastic Surgical Center of Mississippi
• Noah Pogue, RN
• Jason Polk
• Jamye Pollard, DNP, CRNA
• Mary Claire Ponder, APRN
• Mary Ellen Porter, NP
• Posterity Men'S Health, P.C.
• Selena M Powe, FNP

• Family Nurse Practitioner in Flowood, MS
• Providers in Flowood, 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 Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.