BEAUTIFUL MINDS MENTAL HEALTH SERVICES
NPI 1770213928
Nurse Practitioner - Psychiatric/Mental Health in Bolivar, TN
About Beautiful Minds Mental Health Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BEAUTIFUL MINDS MENTAL HEALTH SERVICES (NPI 1770213928) is a healthcare organization registered as a psychiatric/mental health in Bolivar, Tennessee and active in the NPI registry since June 2022. The organization lists Shanna Shackelford, Aprn, Pmhnp, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Beautiful Minds Mental Health Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Beautiful Minds Mental Health Services, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Beautiful Minds Mental Health Services's NPI number?
The NPI number for Beautiful Minds Mental Health Services is 1770213928. It was assigned to this organization in the NPPES registry on June 11, 2022.
Where is Beautiful Minds Mental Health Services located?
Beautiful Minds Mental Health Services is located at 11100 Old Hwy 64, Bolivar, TN 38008. The listed phone number is (901) 300-6808.
What is Beautiful Minds Mental Health Services's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Beautiful Minds Mental Health Services enrolled in Medicare?
Yes. Beautiful Minds Mental Health Services is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Beautiful Minds Mental Health Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Beautiful Minds Mental Health Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Beautiful Minds Mental Health Services was last updated on September 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Beautiful Minds Mental Health Services · NPI 1770213928
Psychiatric/Mental Health organization in Bolivar, Tennessee. Organization record, active in the CMS NPPES registry since June 11, 2022.
## Identity
- **NPI:** 1770213928 (Entity type: Organization)
- **Enumerated:** June 11, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Shanna Shackelford, APRN, PMHNP
## Practice location
- **Address:** 11100 OLD HWY 64, Bolivar, TN 38008
- **Phone:** (901) 300-6808
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 19, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1770213928) · Data from the CMS NPPES public registry.