Individual provider Active NPI

Cameron A Shearer Sr., M.D.

  • Family Medicine Physician
  • Mount Juliet, TN
National Provider Identifier
1437138641
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD15792 Issued in TN
Practice address
3500 N Mount Juliet Rd
Mount Juliet, TN 37122-3078
Phone
(615) 758-5672
Fax
(615) 758-5609
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD15792 TN Primary

Addresses

Primary practice location

3500 N Mount Juliet Rd
Mount Juliet, TN 37122-3078

Mailing address

3500 N Mount Juliet Rd
Mount Juliet, TN 37122-3078
Phone (615) 758-5672

Other identifiers 1

IdentifierTypeStateIssuer
3010169MedicaidTN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120213000173 TN Practitioner - Family Practice 8628235025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD15792TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Wilson Family Practice Center, P.C. CurrentSince Jun 1, 2000 Accepting new patients

Locations

3500 N Mount Juliet Rd
Ste 201
Mt Juliet, TN 37122
Phone (615) 758-5672

3500 N Mount Juliet Rd
Mt Juliet, TN 37122
Phone (615) 758-5672

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1478

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1437138641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N MOUNT JULIET RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223078",
            "telephone_number": "615-758-5672",
            "fax_number": "615-758-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 N MOUNT JULIET RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223078",
            "telephone_number": "615-758-5672",
            "fax_number": "615-758-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "CAMERON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD15792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3010169",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

Verify at the official NPI Registry.