SHANE LEE WHITESIDE


Address: 152 Highway 7 S, Oxford, MS 38655-5392
Phone: 6622347521

SHANE LEE WHITESIDE (NPI# 1174174502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174174502
Entity Type Individual
Full Name SHANE LEE WHITESIDE
Practice Address 152 Highway 7 S
Oxford
MS 38655-5392
Mailing Address 5280 County Road 220
Water Valley
MS 38965-6221
Practice Telephone 6622347521
Practice Fax Number 6622363071
Enumeration Date 2019-09-26
Last Update Date 2019-09-26
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist Other Service Providers

Office Location

Street Address 152 HIGHWAY 7 S
City OXFORD
State MS
Zip Code 38655-5392

Providers in the same location

NPI Name Taxonomy Address Enumeration
1649374265 Mary Sue Speck Counselor 152 Highway 7 S, Oxford, MS 38655-5392 2006-09-12
1396346565 Macy Lillian Newcomb Social Worker 152 Highway 7 S, Oxford, MS 38655-5392 2020-11-04
1760082580 Kimberly Eve Spence Peer Specialist 152 Highway 7 S, Oxford, MS 38655-5392 2020-10-30
1932707999 Tanya Evans Registered Nurse 152 Highway 7 S, Oxford, MS 38655-5392 2020-10-13
1578179545 Tiffany Nail Registered Nurse 152 Highway 7 S, Oxford, MS 38655-5392 2020-09-16
1255947248 Macarah Morris Counselor 152 Highway 7 S, Oxford, MS 38655-5392 2020-09-16
1073128641 Adole Natasha Muruako Counselor 152 Highway 7 S, Oxford, MS 38655-5392 2020-09-10
1174137673 Kristen Lindsey Cauley Social Worker 152 Highway 7 S, Oxford, MS 38655-5392 2020-09-02
1447863741 Elizabeth Danielle Cornelius Counselor 152 Highway 7 S, Oxford, MS 38655-5392 2020-08-26
1316550759 Angel Simmons Counselor 152 Highway 7 S, Oxford, MS 38655-5392 2020-08-25
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619585809 Oxford Treatment Center, LLC Substance Abuse Rehabilitation Facility 616 Commerce Parkway, Oxford, MS 38655 2020-07-14
1760044465 Lindsay Low Beauchamp Speech-Language Pathologist 169 Ms-6 #102, Oxford, MS 38655 2019-07-02
1861058075 Tomiko D Mackey Social Worker 100 Carriage Cove, Oxford, MS 38655 2019-05-13
1174090039 Derionne Brooks Specialist/Technologist 972 Hathorn Road, University, MS 38655 2018-10-30
1497236327 Providence Companion Care Nurse's Aide 317 Heritage Dr Ste 3b, Oxford, MS 38655 2018-08-28
1255817292 Marcela Caroline Weber Counselor 152 Mississippi 7 South, Oxford, MS 38655 2018-07-12
1649775123 Oxford Outpatient Center, LLC Clinic/Center 611 Commerce Pkwy, Oxford, MS 38655 2018-03-27
1073039962 Sharon Yvette Holloway Social Worker 152 Hwy and South, Oxford, Ms 38655, Oxford, MS 38655 2017-08-22
1447774682 Courtney M Purvis Physical Therapist 300 Enterprise Dr Ste B, Oxford, MS 38655 2017-07-31
1649716580 Taylor Lynn Smith Counselor 152 Ms-7, Oxford, MS 38655 2017-01-17
Find all providers in zip 38655

Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Notes: Source: National Uniform Claim Committee [7/1/2014: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1235768680 Matthew Milz Peer Specialist 145o S Lapeer Rd, Oxford, MI 48371-4982 2020-04-07
1760082580 Kimberly Eve Spence Peer Specialist 152 Highway 7 S, Oxford, MS 38655-5392 2020-10-30
1962031468 Frank Pace Peer Specialist 152 Highway 7 S, Oxford, MS 38655-5392 2020-04-06
1982230058 Hannah Jade Mixon Peer Specialist 152 Highway 7 S, Oxford, MS 38655-5392 2020-03-20
1700417110 Jennifer Nicole Zaha Peer Specialist 152 Highway 7 S, Oxford, MS 38655-5392 2020-02-04
1942847652 Suzanne Shepherd Peer Specialist 152 Highway 7 S, Oxford, MS 38655-5392 2019-12-02
1730720012 Dixie Carol Thetford Peer Specialist 152 Highway 7 S, Oxford, MS 38655-5392 2019-10-08
1336790674 Joshua M Walston Peer Specialist 152 Highway 7 S, Oxford, MS 38655-5392 2019-09-27
1568011195 Kathryn Burman Peer Specialist 1450 S Lapeer Rd, Oxford, MI 48371-6108 2019-09-06
1922652999 Shanith Nicole Tedford Peer Specialist 152a Highway 7 S, Oxford, MS 38655-5392 2019-07-29
Find all providers in OXFORD

Competitor

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City OXFORD
Zip Code 38655

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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