Dr Garrett C Shepherd

Primary specialty

OptometristTaxonomy code 152W00000X

License

2600 Issued in TN

Legal business name

DR GARRETT C SHEPHERD

Practice address

45 N Dixie Ave
Cookeville, TN 38501

Phone

(931) 526-2022

Fax

(931) 528-1230

NPI assigned

Jun 6, 2018

Organization subpart

No

Name

Garrett C Shepherd, ODNPI 1609827542

Title

Owner, Doctor

Phone

(931) 526-2022

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Garrett Clark Shepherd, O.D.

  • Optometrist
  • Cookeville, TN
  • NPI 1609827542

  Optometrist, TN

  Medicare reassignment Care Compare group NPD Authorized official
• Jonathan Adam Coble, O.D.

  • Optometrist
  • Cookeville, TN
  • NPI 1689009177

  Optometrist, TN

  Medicare reassignment Care Compare group NPD

Medicare fee-for-service enrollment

Enrolled in TN

Locations

• Huddleston & Shepherd Family Vision Doing business as
• Smith County Advanced Eye Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 16, 2018.

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1629560438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 N DIXIE AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013372",
            "telephone_number": "931-526-2022",
            "fax_number": "931-528-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N DIXIE AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "38501",
            "telephone_number": "931-526-2022",
            "fax_number": "931-528-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "507 Gordonsville Hwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Gordonsville",
            "state": "TN",
            "postal_code": "385634652",
            "country_code": "US",
            "telephone_number": "615-683-5550",
            "fax_number": "615-683-8899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR GARRETT C SHEPHERD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER, DOCTOR",
        "authorized_official_telephone_number": "931-526-2022",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3946671",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huddleston & Shepherd Family Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smith County Advanced Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smith County Advanced Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Donohue, CRNA
• Daniel H Donovan, MD
• Dornbier Enterprise Inc
• Matthew M Dougherty, D.O.
• Dale E Douglas, M.D.
• Dr. Albert E. Hensel, III
• Dr. Andy Thompson
• Dr. Mark Lynn & Associates, PLLC
• Dr. Richard Dycus
• Joshua Dragan, FNP-C

• All providers in Cookeville, TN
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.