Mrs Shatarra Tavonia Salley, APRN, FNP-C, PMHNP - Medicare Nurse Practitioner in Boiling Springs, SC

Mrs Shatarra Tavonia Salley, APRN, FNP-C, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Boiling Springs, South Carolina. She went to University Of South Carolina School Of Medicine and graduated in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Prisma Health University Medical Group and her current practice location is 2400 Boiling Springs Rd, Boiling Springs, South Carolina. You can reach out to her office (for appointments etc.) via phone at (864) 599-0731.

Mrs Shatarra Tavonia Salley is licensed to practice in South Carolina (license number 24906) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1639795859.

Contact Information

Mrs Shatarra Tavonia Salley, APRN, FNP-C, PMHNP
2400 Boiling Springs Rd,
Boiling Springs, SC 29316-5304
(864) 599-0731
(864) 599-0791



Provider's Profile

Full NameMrs Shatarra Tavonia Salley
GenderFemale
SpecialityNurse Practitioner
Experience4 Years
Location2400 Boiling Springs Rd, Boiling Springs, South Carolina
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Shatarra Tavonia Salley attended and graduated from University Of South Carolina School Of Medicine in 2020
  NPI Data:
  • NPI Number: 1639795859
  • Provider Enumeration Date: 06/23/2020
  • Last Update Date: 02/07/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8921485467
  • Enrollment ID: I20220523000080

Medical Identifiers

Medical identifiers for Mrs Shatarra Tavonia Salley such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639795859NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 24906 (South Carolina)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 24906 (South Carolina)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Prisma Health Greenville Memorial HospitalGreenville, SCHospital
Spartanburg Medical CenterSpartanburg, SCHospital
Prisma Health Patewood HospitalGreenville, SCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Prisma Health University Medical Group83259509832201

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Shatarra Tavonia Salley allows following entities to bill medicare on her behalf.
Entity NamePrisma Health University Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295763217
PECOS PAC ID: 8325950983
Enrollment ID: O20031103000238

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Entity NameItrust Wellness Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629517222
PECOS PAC ID: 0648532028
Enrollment ID: O20180322002663

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shatarra Tavonia Salley is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Shatarra Tavonia Salley, APRN, FNP-C, PMHNP
121 Commons Way,
Greenville, SC 29611-3850

Ph: (864) 520-2020
Mrs Shatarra Tavonia Salley, APRN, FNP-C, PMHNP
2400 Boiling Springs Rd,
Boiling Springs, SC 29316-5304

Ph: (864) 599-0731

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Read more News

› Verified 7 days ago


Nurse Practitioner Nurses in Boiling Springs, SC

Blair Gault,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1888 Boiling Springs Rd, Boiling Springs, SC 29316
Phone: 866-389-2727    
Mrs. Constance Audrianna Mudda, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2400 Boiling Springs Rd, Boiling Springs, SC 29316
Phone: 864-599-0731    Fax: 864-599-0791
Rebecca Joy Brown, PNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 316 Village Creek Dr, Boiling Springs, SC 29316
Phone: 864-327-9003    Fax: 800-253-0649
Charlotte Anne Davis, APRN, CPNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 316 Village Creek Dr, Boiling Springs, SC 29316
Phone: 864-327-9003    
Virginia Lee Ivey-mingione, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 110 Parris Bridge Road, Boiling Springs, SC 29316
Phone: 864-599-1998    
Jennifer Nicole Gahan, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1888 Boiling Springs Rd, Boiling Springs, SC 29316
Phone: 864-599-0920    
Felisha Booker,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1214 Turning Leaf Cir, Boiling Springs, SC 29316
Phone: 864-814-8660    

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