Shelly Gunnell Roark, NURSE PRACTITIONER in Hattiesburg, MS

Shelly Gunnell Roark, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Women's Health" in Hattiesburg, Mississippi. She graduated from nursing school in 2016 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southern Women's Health, Pllc and her current practice location is 5003 Hardy St Ste 350, Hattiesburg, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 268-9393.

Shelly Gunnell Roark is licensed to practice in Mississippi (license number 902947) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1083170559.

Contact Information

	Shelly Gunnell Roark, NURSE PRACTITIONER
	5003 Hardy St Ste 350, Hattiesburg, MS 39402-1323
	(601) 268-9393
	(601) 268-9559

Map and Direction

Provider's Profile

Full Name	Shelly Gunnell Roark
Gender	Female
Speciality	Nurse Practitioner
Experience	9 Years
Location	5003 Hardy St Ste 350, Hattiesburg, Mississippi
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Shelly Gunnell Roark graduated from nursing school in 2016

NPI Data:

NPI Number: 1083170559
Provider Enumeration Date: 02/20/2019
Last Update Date: 02/24/2025

Medicare PECOS Information:

PECOS PAC ID: 2163763103
Enrollment ID: I20190401001576

Medical Identifiers

Medical identifiers for Shelly Gunnell Roark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083170559	NPI	-	NPPES
108317055	Medicaid	MS
PENDING	Medicaid	MS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LC1500X	Nurse Practitioner - Community Health	902947 (Mississippi)	Secondary
363LW0102X	Nurse Practitioner - Women's Health	902947 (Mississippi)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Southern Women's Health, Pllc	2567497985	41

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shelly Gunnell Roark allows following entities to bill medicare on her behalf.

Entity Name	Family Health Center, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760488357 PECOS PAC ID: 9638163348 Enrollment ID: O20040414000267

Entity Name	Southern Women's Health, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174744379 PECOS PAC ID: 2567497985 Enrollment ID: O20051004000733

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shelly Gunnell Roark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shelly Gunnell Roark, NURSE PRACTITIONER 6524 U S Highway 98, Hattiesburg, MS 39402-8569 Ph: (601) 268-9393	Shelly Gunnell Roark, NURSE PRACTITIONER 5003 Hardy St Ste 350, Hattiesburg, MS 39402-1323 Ph: (601) 268-9393

Reviews and Comments

Nurse Practitioner Nurses in Hattiesburg, MS

Mrs. Merrick Greene Jackson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3688 Veterans Memorial Dr Ste 200, Hattiesburg, MS 39401 Phone: 601-554-7400
Mrs. Lisa Deloris Slade, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 605 Stadium Dr, Hattiesburg, MS 39401 Phone: 601-450-0310 Fax: 601-450-0321
Sarah Alyssa Smith, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5001 Hardy St, Hattiesburg, MS 39402 Phone: 601-268-8000
Lyndell Sue Lee, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6051 Highway 49, Hattiesburg, MS 39401 Phone: 601-288-7000
Ms. Laura Claire Singley, WHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 62 Old Airport Rd, Hattiesburg, MS 39401 Phone: 601-544-4500
Kisha L Knight, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 404 Lillie Burney St, Hattiesburg, MS 39401 Phone: 601-450-6500 Fax: 601-450-6503
Melissa Ruth Tolar, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6051 U S Highway 49, Hattiesburg, MS 39401 Phone: 601-288-1212

Shelly Gunnell Roark, NURSE PRACTITIONER - Medicare Nurse Practitioner in Hattiesburg, MS