SHELLEY SMITH (NPI# 1861410458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861410458 |
| Entity Type | Individual |
| Full Name | SHELLEY SMITH |
| Credential | CFNP |
| Practice Address |
1900 Grandview Dr Grenada MS 38901-5066 |
| Practice Telephone | 6622265121 |
| Practice Fax Number | 6622267529 |
| Mailing Telephone | 6622265121 |
| Mailing Fax Number | 6622267529 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R742805 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00125605 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734264 | Shelley Baird Smith | Counselor | 265 S St Andrews Pl, Los Angeles, CA 90004-5029 | 2020-06-12 |
| 1376083196 | Shelley Tashina Smith | Counselor | 304 Arlington Dr, Vidalia, GA 30474-8935 | 2017-02-27 |
| 1649579905 | Shelley Elizabeth Smith | Counselor | 910 Arbor Knoll Blvd, Antioch, TN 37013-5353 | 2011-03-24 |
| 1417260290 | Shelley Wetzel Smith | Hearing Instrument Specialist | 1528 Common St Ste 5, New Braunfels, TX 78130-3336 | 2010-07-21 |
| 1881149102 | Shelley Smith | Nurse Practitioner | 129 Bankhead Hwy, Carrollton, GA 30117-3425 | 2016-08-16 |
| 1588039036 | Shelley Ann Smith | Nurse Practitioner | 501 Main St, Gatesville, NC 27938-9424 | 2015-12-09 |
| 1447642269 | Shelley M Smith | Physical Therapy Assistant | 6213 Skyline Dr, Houston, TX 77057-7036 | 2015-03-03 |
| 1922496082 | Shelley Smith | Counselor | 1737 Linwood Blvd, Oklahoma City, OK 73106-5037 | 2014-12-24 |
| 1114329380 | Shelley Smith | Veterinarian | 895 Bridgeport Ave, Shelton, CT 06484-4621 | 2014-09-19 |
| 1124318647 | Shelley V Smith | Pharmacist | 8830 Albemarle Rd, Charlotte, NC 28227-2616 | 2011-04-18 |
| Street Address |
1900 GRANDVIEW DR |
| City | GRENADA |
| State | MS |
| Zip Code | 38901-5066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326008400 | Kimberley Janet Farmer | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901 | 2006-03-24 |
| 1841620846 | State of Mississippi-university of Mississippi Medical Center | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901-5066 | 2013-11-13 |
| 1568683878 | Aimee Robinson Watts | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901 | 2007-05-02 |
| 1669578894 | Grenada Lake Medical Center | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901-5066 | 2006-09-15 |
| 1184644007 | Grenada Clinic for Women, Pa | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901-5066 | 2006-07-21 |
| 1043238637 | Thomas Holden | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901-5066 | 2006-07-18 |
| 1952329542 | Sidney Bondurant | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901-5066 | 2006-07-18 |
| 1588698542 | William Profilet Jr. | Obstetrics & Gynecology | 1900 Grandview Dr, Grenada, MS 38901-5066 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902435118 | The Mane Physician | Prosthetic/Orthotic Supplier | 94 Spain Drive, Grenada, MS 38901 | 2020-04-08 |
| 1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
| 1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
| 1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
| 1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
| 1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
| Find all providers in zip 38901 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1306126263 | Charles Raymond Jordan | Nurse Practitioner | 1350 Sunset Dr Ste B, Grenada, MS 38901-4079 | 2011-08-24 |
| 1144400607 | Family Health Clinic of Grenada | Nurse Practitioner | 1117 Sunset Dr Ste 104, Grenada, MS 38901-4080 | 2007-11-13 |
| 1194947754 | Shonda Jacqueline Phelon | Nurse Practitioner | 1970 Grandview Dr, Grenada, MS 38901-5066 | 2007-05-03 |
| 1629103510 | Sandra Flint Melton | Nurse Practitioner | 1241 S Mound St Ste A, Grenada, MS 38901-4515 | 2007-02-22 |
| 1619987427 | Debbie Elizabeth Mcgehee | Nurse Practitioner | 100 East Monroe Street, Grenada, MS 38901-4080 | 2006-08-08 |
| 1720057565 | Cynthia C Dotson | Nurse Practitioner | 965 Avent Dr Ste 105, Grenada, MS 38901-5045 | 2006-03-15 |
| 1841299500 | Nell Catherine Brock | Nurse Practitioner | 108 Vfw Rd, Grenada, MS 38901 | 2005-07-15 |
| 1013515980 | Aarrin Marie Mcdougal | Nurse Practitioner | 100 E Monroe St, Grenada, MS 38901-5249 | 2020-10-13 |
| 1205441375 | Alison Campbell | Nurse Practitioner | 1117 Sunset Dr Ste 104, Grenada, MS 38901-4080 | 2020-09-15 |
| Find all providers in GRENADA | ||||
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| 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.