Individual provider Active NPI

Austin Jordan Shinaberry, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Bartlett, TN
National Provider Identifier
1053175661
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
6705 Issued in TN
Practice address
6490 Memphis Arlington Rd
Bartlett, TN 38135-7417
Phone
(901) 762-1531
Fax
(901) 762-1532
NPI assigned
Feb 13, 2024
Last updated
Sep 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6705 TN Primary

Addresses

Primary practice location

6490 Memphis Arlington Rd
Bartlett, TN 38135-7417

Mailing address

6490 Memphis Arlington Rd Ste 106
Bartlett, TN 38135-7439
Phone (901) 762-1531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251008000004 TN Practitioner - Physician Assistant 2264939172 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamad Ahmad MD PCGroup PAC ID 0749553816, shared by 4 NPIs, 14 clinicians

Practice addresses (Care Compare)

6490 Memphis Arlington Rd
Suite 106
Bartlett, TN 38135-7439
Phone (901) 762-1531

9301 Poplar Ave
Germantown, TN 38138-7906
Phone (901) 587-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hamad Ahmad MD PC CurrentSince Sep 15, 2025 Accepting new patients
Hamad Ahmad MD PC CurrentSince Sep 15, 2025 Accepting new patients
Hamad Ahmad MD PC CurrentSince Sep 15, 2025 Accepting new patients
Hamad Ahmad MD PC CurrentSince Sep 15, 2025 Accepting new patients

Locations

9301 Poplar Ave
Germantown, TN 38138
Phone (901) 587-6100

4772 Navy Rd
Ste A
Millington, TN 38053
Phone (901) 873-0570

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1053175661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6490 MEMPHIS ARLINGTON RD STE 106",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381357439",
            "telephone_number": "901-762-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6490 MEMPHIS ARLINGTON RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381357417",
            "telephone_number": "901-762-1531",
            "fax_number": "901-762-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINABERRY",
        "first_name": "AUSTIN",
        "middle_name": "JORDAN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-13",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "6705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

Verify at the official NPI Registry.