Doctor profile · Federal record
Dr. Shelly Roark, Nurse Practitioner
Women's Health Nurse Practitioner (CMS: Nurse Practitioner) · Community Health Nurse Practitioner · Hattiesburg, MS
- NPI 1083170559
- Accepts Medicare
- 10 yrs in practice
- Female
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
5003 Hardy St Ste 350
Hattiesburg, MS 394021323
(601) 268-9393
fax (601) 268-9559 - Mailing address
-
6524 U S Highway 98
Hattiesburg, MS 394028569
Credentials & registration
- NPI registered
- February 2019 — 7 yrs on file
- Profile last updated
- February 24, 2025
- Year of graduation
- 2016 — 10 yrs since
- Specialty taxonomy
- 363LW0102X — NUCC code
- State license (1)
- Mississippi #902947
- Medicaid (2)
- MS #108317055 · MS #PENDING
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1083170559. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$42
Transactions
2
Manufacturers
2
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Merck Sharp & Dohme LLC | 1 | $25.07 | |
| Xeris Pharmaceuticals, Inc. | 1 | $17.31 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
31
Patients
13
Total drug cost
$192
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Fluconazole | Generic | 17 | 13 | $80 |
| Metronidazole | Generic | 14 | 0 | $112 |
Frequently asked questions
What is Dr. Shelly Roark's medical specialty?
Dr. Shelly Roark practices Women's Health Nurse Practitioner in Hattiesburg, MS.
Where does Dr. Shelly Roark practice?
Dr. Shelly Roark practices at 5003 Hardy St Ste 350, Hattiesburg, MS 394021323. Office phone: 6012689393.
What is Dr. Shelly Roark's NPI?
Dr. Shelly Roark's National Provider Identifier (NPI) is 1083170559, issued by NPPES.
Does Dr. Shelly Roark accept Medicare assignment?
Yes. Dr. Shelly Roark accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.