Individual provider Active NPI

Chasity Michelle Sisson, FNP

  • Family Nurse Practitioner
  • Shubuta, MS
National Provider Identifier
1992983829
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R871983 Issued in MS
Practice address
130 N High St
Shubuta, MS 39360-8870
Phone
(601) 687-1391
NPI assigned
Feb 1, 2008
Last updated
May 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R871983 MS Primary

Addresses

Primary practice location

130 N High St
Shubuta, MS 39360-8870

Mailing address

130 N High St
Shubuta, MS 39360-8870
Phone (601) 687-1391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20150401000450 MS Practitioner - Nurse Practitioner 5890983381 Reassigns benefits to 1 organization
I20200207000638 FL Practitioner - Nurse Practitioner 5890983381 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Health Services,Inc. CurrentSince Nov 5, 2014 Accepting new patients
Outreach Health Services,Inc. CurrentSince Nov 5, 2014 Accepting new patients
Nation's Best Family Health Care PLLC CurrentSince Jan 1, 2020 Accepting new patients
Amaze Professional Medical Services PC Past Accepting new patients

Locations

1514 W 23rd St
Panama City, FL 32405
Phone (850) 481-1101

309 N Pine Ave
Heidelberg, MS 39439
Phone (601) 687-1391

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1992983829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N HIGH ST",
            "city": "SHUBUTA",
            "state": "MS",
            "postal_code": "393608870",
            "telephone_number": "601-687-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N HIGH ST",
            "city": "SHUBUTA",
            "state": "MS",
            "postal_code": "393608870",
            "telephone_number": "601-687-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSON",
        "first_name": "CHASITY",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-01",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R871983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shubuta, MS

Sources for this page

Verify at the official NPI Registry.