NPIMap

Individual provider Active NPI

Tara S Shields, MD

  • Internal Medicine Physician
  • Johnson City, TN
National Provider Identifier
1215347240
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56281 Issued in TN
Practice address
301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641
Phone
(423) 794-5520
Fax
(423) 282-6940
NPI assigned
Apr 29, 2014
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 56281 TN Primary

Addresses

Primary practice location

301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641

Mailing address

PO Box 632476
Cincinnati, OH 45263-2476
Phone (423) 794-5520

Other names 1

  • Tara Renae Samples Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171006001142 TN Practitioner - Internal Medicine 2062707318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
East Tennessee State University Quillen College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

301 Med Tech Pkwy
Johnson City, TN 37604-2364
Phone (423) 794-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Covenant Medical Group, Inc. Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Covenant Medical Group, Inc CurrentSince Sep 1, 2017 Accepting new patients

Locations

314 Rogosin Dr
Elizabethton, TN 37643
Phone (423) 433-6630

215 E Springbrook Dr
Johnson City, TN 37601
Phone (423) 530-7900

301 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 794-5500

301 Med Tech Pkwy
Ste 240
Johnson City, TN 37604
Phone (423) 794-5520

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

100 Vermont Ave
Oak Ridge, TN 37830
Phone (865) 482-1777

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tarashields@sofha.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1215347240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632476",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632476",
            "telephone_number": "423-794-5520",
            "fax_number": "423-282-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MED TECH PKWY STE 240",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042641",
            "telephone_number": "423-794-5520",
            "fax_number": "423-282-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "TARA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "56281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "SAMPLES",
            "middle_name": "RENAE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.