SHELLY BOONE (NPI# 1750797874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750797874 |
| Entity Type | Individual |
| Full Name | SHELLY BOONE |
| Credential | CFNP |
| Practice Address |
526 Deerfield Dr Forest MS 39074-6005 |
| Mailing Address |
12953 Highway 501 Forest MS 39074-5647 |
| Practice Telephone | 6014690291 |
| Mailing Telephone | 6015363979 |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R863942 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093722613 | Shelly S Boone | Nurse Practitioner | 1025 Machester Ave, Wabash, IN 46992-1496 | 2006-08-03 |
| Street Address |
526 DEERFIELD DR |
| City | FOREST |
| State | MS |
| Zip Code | 39074-6005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245489186 | Independent Healthcare Management, Inc. | Clinic/Center | 526 Deerfield Dr, Suite C, Forest, MS 39074-6005 | 2008-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467095927 | Tamatha Nicole Owen | Nurse Practitioner | 1061 Highway 35 S, Forest, MS 39074 | 2019-10-28 |
| 1154687838 | Region Ten Commission On Mental Health | Clinic/Center | 13682 Hwy 80 West, Forest, MS 39074 | 2012-04-06 |
| 1053567636 | Cathy G Cooper | Physical Therapist | 813 West 3rd Street, Forest, MS 39074 | 2008-08-14 |
| 1487866158 | Terry Ann Meadows | Clinic/Center | 330 North Broad St, Forest, MS 39074 | 2007-05-04 |
| 1770702144 | Randy K Reynolds | Dentist | 208 West 3rd Street, Forest, MS 39074 | 2007-04-24 |
| 1215067293 | John B. Smith, Jr. Dmd, Pa | Dentist | 1040 Highway 35 South, Drawer 30, Forest, MS 39074 | 2007-03-07 |
| 1225189244 | Douglas F Harvel, Jr | Dentist | 1040 Highway 35 S, Forest, MS 39074 | 2007-01-16 |
| 1861542433 | Forest Dental Practice Pllc | Dentist | Po Drawer 30, Forest, MS 39074 | 2007-01-12 |
| 1306996970 | John B Smith Jr. | Dentist | 1040 Hwy 35 South, Forest, MS 39074 | 2007-01-12 |
| 1295821072 | Buddy Lee Eady | Chiropractor | 500 East 3rd St., Forest, MS 39074 | 2006-10-05 |
| Find all providers in zip 39074 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063963874 | Renee Cundiff Nauful | Nurse Practitioner | 1109 Chesdin Rd, Forest, VA 24551-4471 | 2016-10-17 |
| 1104247386 | Natalie Austin Desseyn | Nurse Practitioner | 1606 Helmsdale Dr, Forest, VA 24551-4870 | 2013-12-14 |
| 1174892822 | Claudia Bowman | Nurse Practitioner | 1123 Highway 35 S, Forest, MS 39074-8829 | 2011-12-27 |
| 1467449587 | Ruth H Robertson | Nurse Practitioner | 2007 Graves Mill Rd, Forest, VA 24551-2656 | 2005-10-04 |
| 1528672276 | Megan Elizabeth Mcdaniel | Nurse Practitioner | 330 N Broad St, Forest, MS 39074-3508 | 2020-09-01 |
| 1477104271 | Leigh Ellen Gault | Nurse Practitioner | 1123 Highway 35 S, Forest, MS 39074-8829 | 2019-09-23 |
| 1518522960 | Lisa Swezey | Nurse Practitioner | 1111 Corporate Park Dr Ste D, Forest, VA 24551-2279 | 2019-05-01 |
| 1952865214 | Donna Wedgeworth | Nurse Practitioner | 1 Medical Ln Ste B, Forest, MS 39074-4039 | 2019-01-30 |
| 1073080578 | Marlee Rachel Bryant | Nurse Practitioner | 2103 Graves Mill Rd, Forest, VA 24551-2675 | 2018-11-01 |
| 1609323450 | Megan Otto | Nurse Practitioner | 330 N Broad St, Forest, MS 39074-3508 | 2016-09-08 |
| Find all providers in FOREST | ||||
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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.