MRS. SHAWNTA SENICE GANDY
NPI 1366851321
Nurse Practitioner - Family in Petal, MS
NPI Status: Active since August 04, 2014
Contact Information
27 CANDELABRA ST
PETAL, MS
ZIP 39465
Phone: (601) 620-8011
- Individual
- Female
- Years of Experience 13
- Nurse Practitioner
- Family
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About SHAWNTA GANDY
This page provides the complete NPI Profile along with additional information for Shawnta Gandy, a provider established in Petal, Mississippi with a medical specialization in Nurse Practitioner, focusing in family and more than 13 years of experience. The healthcare provider is registered in the NPI registry with number 1366851321 assigned on August 2014. The practitioner's primary taxonomy code is 363LF0000X with license number R883735 (MS). The provider is registered as an individual and her NPI record was last updated 11 years ago.
- NPI
- 1366851321
- Provider Name
- MRS. SHAWNTA SENICE GANDY
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 27 CANDELABRA ST PETAL, MS 39465
- Location Phone
- (601) 620-8011
- Mailing Address
- 27 CANDELABRA ST PETAL, MS 39465
- Mailing Phone
- (601) 620-8011
- Medical School Name
- OTHER
- Graduation Year
- 2014
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-04-2014
- Last Update Date
- 10-05-2015
- Code Navigator
A nurse practitioner (NP) like Shawnta Gandy is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- R883735
- License State
- MS
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 163W00000X | Nursing Service Providers | Registered Nurse | R883735 (MS) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Molina Gold Standard - HMO
- Molina Silver Standard - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Essential (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Copay Focus + $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Gold Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Value + ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Silver Advantage + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Shawnta Gandy is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Shawnta Gandy is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3577889252
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20150225000653, I20240509001873
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Hospital Beds (DB000N)
Hospital bed, variable height, hi-lo, with any type side rails, with mattress (HCPCS:E0255)
1 DME suppliers used 32 Medicare Claims 32 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
3 DME suppliers used 54 Medicare Claims 54 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Initial nursing facility visit per day, typically 35 minutes
Initial nursing facility visit per day, typically 45 minutes
Nursing facility annual assessment, typically 30 minutes
Nursing facility discharge management, more than 30 minutes
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 2,156 times for 163 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 481 times for 95 patientsAn initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
This service was performed 14 times for 14 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 74 times for 72 patientsAn annual assessment at a nursing facility is a routine check-up that typically lasts about 30 minutes. It's a chance for healthcare professionals to evaluate your overall health and wellness, monitor any ongoing conditions, and adjust care plans as needed.
This service was performed 12 times for 12 patientsNursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
This service was performed 29 times for 29 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.12 for a new patient copayment and $23.05 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 39465 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $80.5
- Minimum New Patient Price $51.65
- Maximum New Patient Price $159.18
- Average New Patient Copayment $20.12
- Minimum New Patient Copayment $12.91
- Maximum New Patient Copayment $39.79
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $92.2
- Minimum Established Patient Price $16.15
- Maximum Established Patient Price $129.61
- Average Established Patient Copayment $23.05
- Minimum Established Patient Copayment $4.03
- Maximum Established Patient Copayment $32.4
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Dementia: Cognitive Assessment | 25% | 72 |
| Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period | ||
| Falls: Screening for Future Fall Risk | 21% | 135 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Patient-Specific Education | 12% | 99 |
| The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Preventive Care and Screening: Influenza Immunization | 11% | 100 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
| Provide Patient Access | 19% | 99 |
| For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1366851321, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366851321, enumerated as an "individual" on August 04, 2014.
The provider is located at 27 CANDELABRA ST PETAL, MS 39465 and the phone number is (601) 620-8011.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: Molina Healthcare and UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.
