Individual provider Active NPI

Shere Howald Conway, M.D.

  • Family Medicine Physician
  • Oak Ridge, TN
National Provider Identifier
1619959798
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35002 Issued in TN
Practice address
100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone
(865) 482-1777
Fax
(865) 482-1030
NPI assigned
Nov 15, 2005
Last updated
Nov 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.49791 AL
Family Medicine Physician 207Q00000X 35002 TN Primary
Family Medicine Physician 207Q00000X MD61590783 WA
Family Medicine Physician 207Q00000X 94879 SC
Family Medicine Physician 207Q00000X 127367 MT
Family Medicine Physician 207Q00000X 2025-01900 NC
Family Medicine Physician 207Q00000X G-198937 CA

Addresses

Primary practice location

100 Vermont Ave
Oak Ridge, TN 37830-6471

Mailing address

100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone (865) 482-1777

Other identifiers 3

IdentifierTypeStateIssuer
00057056OtherTNRAILROAD MEDICARE
3879444MedicaidTN
M011026916MedicaidMT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address conway.shere@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MT2 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
I20040318001579 TN Practitioner - Family Practice 6406746767 Reassigns benefits to 1 organization
I20041228000976 MT Practitioner - Family Practice 6406746767 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.49791ALMDFamily Medicine Physician
G-198937CAMDFamily Medicine Physician
127367MTMDFamily Medicine Physician
2025-01900NCMDFamily Medicine Physician
94879SCMDFamily Medicine Physician
MD61590783WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical Mission PLLC Family Medicine CurrentSince Jun 1, 2023 Accepting new patients
Bruce D Fisher DPM PC Past Accepting new patients
First Care Medical Center PC Past Accepting new patients
Glasgow Clinic, Inc. Past Accepting new patients

Locations

150 E Division Rd
Ste 1
Oak Ridge, TN 37830
Phone (865) 205-2942

Interoperability endpoints

  • Direct secure messaging: shere.conway.1@30520.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1619959798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777",
            "fax_number": "865-482-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777",
            "fax_number": "865-482-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "SHERE",
        "middle_name": "HOWALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.49791",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "35002",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61590783",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "94879",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "127367",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2025-01900",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G-198937",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "00057056",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3879444",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M011026916",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "conway.shere@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Vermont Ave",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378306471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.