Shapard H Pryor Jr., MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

16667 Issued in MS

Practice address

1151 N State St
Suite 311
Jackson, MS 39202

Phone

(601) 969-1171

Fax

(601) 969-1173

NPI assigned

Jan 24, 2007

Sex

Male

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

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Anesthesia Group Staffing, LLCGroup PAC ID 2769928795, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Physicians Anesthesia Group Staffing, LLC

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1558102772
  Medicare reassignment Care Compare group
• Jackson Anesthesia Associates PA

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1780737577
  Medicare reassignment NPD
• Jackson Pain Center PA

  • Pain Medicine (Anesthesiology) Physician
  • Jackson, MS
  • NPI 1962823344
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1932254547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "address_2": "SUITE 311",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022407",
            "telephone_number": "601-969-1171",
            "fax_number": "601-969-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "address_2": "SUITE 311",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39202",
            "telephone_number": "601-969-1171",
            "fax_number": "601-969-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYOR",
        "first_name": "SHAPARD",
        "middle_name": "H",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "16667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122046",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Providence Hospice, LLC
• Thomas Prude, PCMHT
• Ellyn Burton Pruett, FNP-C
• Eleanor Karen Pruitt, DMD
• Kelli Elizabeth Pruitt
• Tyranny Pryor
• Rick A Psonak, CPO
• John Austin Puckett, MD
• Zachary Neal Puckett, CPNP-AC/PC
• Krista Puderbaugh, LPC

• Anesthesiology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Anesthesiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.