Active NPI
Jeremy Douglas Shepherd
- Family Nurse Practitioner
- Clarksville, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 37981
- Practice address
- 651 Dunlop LN
Clarksville, TN 37040-5015 - Phone
- (931) 502-1000
- NPI assigned
- Nov 19, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Paramedic | 146L00000X | |||
| Registered Nurse | 163W00000X | 259150 | TN | |
| Family Nurse Practitioner | 363LF0000X | 37981 | TN | Primary |
Addresses
Primary practice location
651 Dunlop LN
Clarksville, TN 37040-5015
Mailing address
651 Dunlop LN
Clarksville, TN 37040-5015
Phone (931) 502-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
520 W Gum St
Marion, KY 42064-1516
Phone (270) 965-1042
651 Dunlop LN
Clarksville, TN 37040-5015
Phone (931) 502-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 259150 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Practice Clinic PSC | Family | Current | Accepting new patients |
| Crittenden Community Hospital LLC | Current | Accepting new patients | |
| Southeastern Emergency Physicians LLC | Current | Accepting new patients | |
| Crittenden Community Hospital LLC | Current | Accepting new patients |
Locations
1325 Highway 76
Clarksville, TN 37043
Phone (615) 788-9324
651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000
9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000
265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/critten-2b2d21fb
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Marion, KY
- NPI 1275097339
-
- Clinic/Center
- Sturgis, KY
- NPI 1013727882
-
- Family Medicine Physician
- Marion, KY
- NPI 1467454041
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Clarksville, TN
- NPI 1285689794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736467200000",
"number": "1134944788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "651 DUNLOP LN",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370405015",
"telephone_number": "931-502-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "651 DUNLOP LN",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370405015",
"telephone_number": "931-502-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "JEREMY",
"middle_name": "DOUGLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-19",
"last_updated": "2025-01-10",
"certification_date": "2025-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "146L00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Paramedic",
"state": null,
"license": null,
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "259150",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "37981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.