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SHAQUALYN TAITE CRNP
NPI 1881211019
Nurse Practitioner - Family in Jackson, AL

Active since July 04, 2020PECOS Enrolled
4005 N COLLEGE AVE, JACKSON, AL 36545(251) 744-6084 Get Directions Write a Review

NPPES record last updated: March 21, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Shaqualyn Taite Crnp NPPES

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

SHAQUALYN TAITE CRNP (NPI 1881211019) is an individual family provider in Jackson, Alabama, licensed in Alabama (1-150563) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881211019
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHAQUALYN TAITECredential: CRNP
Location Address4005 N COLLEGE AVEJackson, AL 36545-2024
Mailing AddressPo Box 306491Nashville, TN 37230-6491
Phone(251) 744-6084
Sole ProprietorNo
Enumeration DateJuly 4, 2020
Last NPPES UpdateMarch 21, 2024
NPPES CertifiedMarch 21, 2024
✔ NPI 1881211019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AL · 1-150563
4005 N COLLEGE AVE, Jackson, AL 36545
Open in Google Maps ↗

Other Names 1

Former Name (1)Shaqualyn Rocker

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shaqualyn Taite Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Shaqualyn Taite reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rural Health Medical Program, Inc
33 mi
Family Medicine
3040 S ALABAMA AVE
Monroeville, AL 36460
  • Reassigned Medicare billing, Alabama enrollment
  • 43 clinicians in this Medicare group
NPI 1457994121 (844) 736-7629
Fast Pace Medical Clinic PLLC
224 mi
Family Medicine
416 N SEMINARY ST STE 1100
Florence, AL 35630
  • Reassigned Medicare billing, Alabama enrollment
  • 179 clinicians in this Medicare group
NPI 1639679962 (931) 253-1110

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36545 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FAST PACE MEDICAL CLINIC PLLC
Clinic/Center (Rural Health)
4005 N COLLEGE AVE
JACKSON, AL 36545
Clarke County (251) 744-6084

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 Shaqualyn Taite's NPI number?

The NPI number for Shaqualyn Taite is 1881211019. It was assigned to this individual provider in the NPPES registry on July 4, 2020. The provider is also known as Shaqualyn Rocker.

Where is Shaqualyn Taite located?

Shaqualyn Taite practices at 4005 N College Ave, Jackson, AL 36545. The listed phone number is (251) 744-6084.

What is Shaqualyn Taite's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shaqualyn Taite enrolled in Medicare?

Yes. Shaqualyn Taite is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shaqualyn Taite's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shaqualyn Taite reassigns Medicare benefits to 2 organizations: Rural Health Medical Program, Inc (Monroeville, AL) and Fast Pace Medical Clinic PLLC (Florence, AL). Each 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 Shaqualyn Taite's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shaqualyn Taite was last updated on March 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.