Individual provider Active NPI

Brandon Alan Shepherd, M.D.

  • Otolaryngology Physician
  • Germantown, TN
National Provider Identifier
1548614290
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
62646 Issued in TN
Practice address
7600 Wolf River Blvd Ste 120
Germantown, TN 38138-1787
Phone
(901) 755-5300
Fax
(901) 682-1362
NPI assigned
Apr 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X T-3211 MS
Otolaryngology Physician 207Y00000X 62646 TN Primary

Addresses

Primary practice location

7600 Wolf River Blvd Ste 120
Germantown, TN 38138-1787

Mailing address

PO Box 2757
Cordova, TN 38088-2757
Phone (901) 755-5300

Other practice location 1

2500 N State St
Otolaryngology Department
Jackson, MS 39216-4500
Phone (601) 984-5160

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210715001210 TN Practitioner - Otolaryngology 9931492568 Reassigns benefits to 1 organization
I20250822000291 MS Practitioner - Otolaryngology 9931492568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Tennessee, HSC, College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mid-South Ear Nose and Throat PCGroup PAC ID 3779568092, 32 clinicians

Practice addresses (Care Compare)

7164 Hacks Cross Rd
Suite 105 106
Olive Branch, MS 38654-4472
Phone (901) 755-5300

7600 Wolf River Blvd
Suite 220
Germantown, TN 38138-1788
Phone (901) 755-5300

Hospital & facility affiliations

  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
  • Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-3211MSMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Ear, Nose, and Throat, P.C. Otolaryngology CurrentSince Jul 1, 2021 Accepting new patients
Mid-South Ear, Nose, and Throat, P.C. Otolaryngology CurrentSince Jul 1, 2021 Accepting new patients
North Internal Medicine, P. C. PastSince Nov 9, 2020 Accepting new patients

Locations

7164 Hacks Cross Rd
Ste 105
Olive Branch, MS 38654

7164 Hacks Cross Rd
Ste 105106
Olive Branch, MS 38654

7164 Hacks Cross Rd
Ste 106
Olive Branch, MS 38654
Phone (662) 895-6455

7378 Yale Rd
Bartlett, TN 38133
Phone (901) 387-0193

7600 Wolf River Blvd
Ste 220
Germantown, TN 38138

7600 Wolf River Blvd
Ste 120
Germantown, TN 38138

Interoperability endpoints

  • Direct secure messaging: bshepherd23602@mlh.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1548614290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2757",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380882757",
            "telephone_number": "901-755-5300",
            "fax_number": "901-753-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 WOLF RIVER BLVD STE 120",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381787",
            "telephone_number": "901-755-5300",
            "fax_number": "901-682-1362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_2": "Otolaryngology Department",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5160",
            "fax_number": "601-984-5085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "BRANDON",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "T-3211",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "62646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.