Shawn Fortenberry Churchill Coy, FNP-BC, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

905512 Issued in MS

Practice address

190 W Main St
Camden, TN 38320-1609

Phone

(731) 213-2662

Fax

(731) 213-2539

NPI assigned

Oct 3, 2006

Last updated

Aug 12, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DC Medical Services IncGroup PAC ID 4688981665, 4 clinicians

Dutch Medical Clinics, IncGroup PAC ID 9234376088, 28 clinicians

Iris Medical GroupGroup PAC ID 0648653360, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Saint Thomas Three Rivers Hospital, Waverly, TN, CCN 441303

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shawn.churchill-coy.1@30029.direct.athenahealth.com

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.

• DC Medical Services Inc

  dba Carney's Family Clinic

  • Family Medicine Physician
  • Camden, TN
  • NPI 1467841742
  Medicare reassignment Care Compare group NPD
• Iris Medical Group

  • Primary Care Clinic/Center
  • Brentwood, TN
  • NPI 1851025902

  Family

  Medicare reassignment Care Compare group NPD
• Dutch Medical Clinics, Inc

  dba Allegro Family Clinics

  • Multi-Specialty Clinic/Center
  • Columbus, MS
  • NPI 1215276175
  Medicare reassignment Care Compare group NPD
• Family Care Clinic of Ripley

  • Nurse Practitioner
  • Ripley, MS
  • NPI 1043386642
  Medicare reassignment NPD
• Heale Counseling, LLC

  • Mental Health Counselor
  • Tupelo, MS
  • NPI 1093410243

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Magnolia Regional Behavioral Health Services

  • Psychiatry Physician
  • Corinth, MS
  • NPI 1033656889
  Medicare reassignment NPD
• Iris Wound Care, PC

  • Clinic/Center
  • Brentwood, TN
  • NPI 1568273605
  NPD (past)

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

• Humphreys County Community Health Services, Inc.

  dba Ascension Saint Thomas Three Rivers

  • Critical Access Hospital
  • Waverly, TN
  • NPI 1235387044
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1255425922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 W MAIN ST",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383201609",
            "telephone_number": "731-213-2662",
            "fax_number": "731-213-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 W MAIN ST",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383201609",
            "telephone_number": "731-213-2662",
            "fax_number": "731-213-2539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205A Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382012024",
            "country_code": "US",
            "telephone_number": "731-352-7907",
            "fax_number": "833-690-3848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1894 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382012206",
            "country_code": "US",
            "telephone_number": "731-207-6496",
            "fax_number": "833-690-3848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30810 Broad St",
            "address_purpose": "LOCATION",
            "city": "Bruceton",
            "state": "TN",
            "postal_code": "383172028",
            "country_code": "US",
            "telephone_number": "731-586-4800",
            "fax_number": "833-690-3848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "306 Highway 641 N",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "TN",
            "postal_code": "383203012",
            "country_code": "US",
            "telephone_number": "731-213-2344",
            "fax_number": "833-690-3848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205A Court Sq",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "TN",
            "postal_code": "383443710",
            "country_code": "US",
            "telephone_number": "731-535-5765",
            "fax_number": "833-690-3848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1731 S Meridian St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "TN",
            "postal_code": "382301827",
            "country_code": "US",
            "telephone_number": "731-678-0055",
            "fax_number": "731-678-0059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2051 US Highway 45 Byp S",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "TN",
            "postal_code": "383822940",
            "country_code": "US",
            "telephone_number": "731-393-7120",
            "fax_number": "833-690-3848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHURCHILL COY",
        "first_name": "SHAWN",
        "middle_name": "FORTENBERRY",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "905512",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MS",
            "license": "R789934",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000032347",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905512",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN0000032347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Raymond Carney, M.D.
• Matthew Carrico, PA-C
• Mickie Carter, MS, PA-C
• CCC Medical Equipment, Inc.
• CCC Medical Equipment, Inc.
• Carlton Lynn Cole
• Christina Cole
• Core Men's Health
• Debra L Davenport, MA, SPE
• Jennifer Dawn Davis, APRN

• Psychiatric/Mental Health Nurse Practitioner in Camden, TN
• Providers in Camden, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.

Verify at the official NPI Registry.