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SHELLY GUNNELL ROARK NURSE PRACTITIONER
NPI 1083170559
Nurse Practitioner - Women's Health in Hattiesburg, MS

Active since February 20, 2019PECOS EnrolledAccepts Medicare Assignment
5003 HARDY ST STE 350, HATTIESBURG, MS 39402(601) 268-9393(601) 268-9559 Get Directions Write a Review

NPPES record last updated: February 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 24, 2025, Feb 6, 2025, Jan 19, 2021 and 1 more (4 updates tracked since 2019).

About Shelly Gunnell Roark Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELLY GUNNELL ROARK NURSE PRACTITIONER (NPI 1083170559) is an individual women's health provider in Hattiesburg, Mississippi, licensed in Mississippi (902947) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1083170559
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameSHELLY GUNNELL ROARKCredential: NURSE PRACTITIONER
Location Address5003 HARDY ST STE 350Hattiesburg, MS 39402-1323
Mailing Address6524 U S Highway 98Hattiesburg, MS 39402-8569 · (601) 268-9393 · Fax (601) 268-9559
Phone(601) 268-9393
Fax(601) 268-9559
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateFebruary 20, 2019
Last NPPES UpdateFebruary 24, 20254 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2025
✔ NPI 1083170559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
License✔ Licensed in MS · 902947
Also ListedNurse Practitioner · Community HealthTaxonomy 363LC1500X · License 902947 (MS)
5003 HARDY ST STE 350, Hattiesburg, MS 39402
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Other Identifiers 2

Medicaid108317055MS
MedicaidPENDINGMS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shelly Gunnell Roark Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163763103
PECOS Enrollment IDI20190401001576
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39402 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shelly Roark's NPI number?

The NPI number for Shelly Roark is 1083170559. It was assigned to this individual provider in the NPPES registry on February 20, 2019.

Where is Shelly Roark located?

Shelly Roark practices at 5003 Hardy St Ste 350, Hattiesburg, MS 39402. The listed phone number is (601) 268-9393.

What is Shelly Roark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Is Shelly Roark enrolled in Medicare?

Yes. Shelly Roark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shelly Roark accept?

Health plans from Molina Healthcare and UnitedHealthcare list Shelly Roark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shelly Roark was last updated on February 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.