Active NPI
Terry Preston Shepherd, M.D.
- Urology Physician
- Knoxville, TN
National Provider Identifier
1417943705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 14409
- Practice address
- 9245 Park West Blvd
Knoxville, TN 37923-4425 - Phone
- (865) 690-3811
- Fax
- (865) 694-7621
- NPI assigned
- Sep 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 14409 | TN | Primary |
Addresses
Primary practice location
9245 Park West Blvd
Knoxville, TN 37923-4425
Mailing address
9245 Park West Blvd
Knoxville, TN 37923-4425
Phone (865) 690-3811
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3031775 | Medicaid | TN | |
| 0347510001 | Other | TN | MEDICARE NSC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14409 | TN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294099200000",
"number": "1417943705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9245 PARK WEST BLVD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379234425",
"telephone_number": "865-690-3811",
"fax_number": "865-694-7621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9245 PARK WEST BLVD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379234425",
"telephone_number": "865-690-3811",
"fax_number": "865-694-7621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "TERRY",
"middle_name": "PRESTON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2011-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TN",
"license": "14409",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3031775",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NSC",
"identifier": "0347510001",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.