NPIMap

Individual provider Active NPI

John Mason Douglas, FNP-BC

  • Family Nurse Practitioner
  • Shelbyville, TN
National Provider Identifier
1730566175
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22447 Issued in TN
Practice address
1114 N Main St Ste a
Shelbyville, TN 37160-2380
Phone
(931) 365-2149
Fax
(931) 492-4257
NPI assigned
May 6, 2015
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22447 TN Primary

Addresses

Primary practice location

1114 N Main St Ste a
Shelbyville, TN 37160-2380

Mailing address

1114 N Main St Ste a
Shelbyville, TN 37160-2380
Phone (931) 365-2149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150528002079 MS Practitioner - Nurse Practitioner 1557681756 Reassigns benefits to 3 organizations
I20170601000895 TN Practitioner - Nurse Practitioner 1557681756 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Maury Regional HospitalGroup PAC ID 4688569718, 31 clinicians

Practice addresses (Care Compare)

1080 N Ellington Pkwy
Lewisburg, TN 37091-2227
Phone (931) 359-6241

1090 N Ellington Pkwy
Lewisburg, TN 37091-2227
Phone (931) 359-0019

1114 N Main St
Suite a
Shelbyville, TN 37160-2380
Phone (931) 652-9369

617 W Main St
Hohenwald, TN 38462-1355
Phone (931) 796-4901

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maury Regional Hospital Current Accepting new patients
Amite County Medical Services, Inc. CurrentSince May 6, 2015 Accepting new patients
Maury Regional Medical Group, Inc Family CurrentSince Jun 1, 2019 Accepting new patients
Champion Medical Care LLC CurrentSince Mar 1, 2026 Accepting new patients
Field Memorial Community Hospital CurrentSince May 19, 2018 Accepting new patients
Maury Regional Hospital Marshall Medical Center CurrentSince Jun 1, 2019 Accepting new patients
Amite County Medical Services, Inc. CurrentSince May 6, 2015 Accepting new patients
Maury Regional Hospital CurrentSince Jul 30, 2018 Accepting new patients
Maury Regional Hospital Current Accepting new patients
Field Memorial Community Hospital CurrentSince May 19, 2018 Accepting new patients
Field Memorial Community Hospital Current Accepting new patients
Maury Regional Hospital CurrentSince Jul 30, 2018 Accepting new patients

Locations

178 Highway 24 E
Centreville, MS 39631
Phone (601) 645-5221

1218 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4114

854 W James M Campbell Blvd
Ste 303
Columbia, TN 38401
Phone (931) 388-8779

617 W Main St
Hohenwald, TN 38462
Phone (931) 796-4901

1090 N Ellington Pkwy
Lewisburg, TN 37091
Phone (931) 270-3676

1090 N Ellington Pkwy
Ste 102
Lewisburg, TN 37091
Phone (931) 359-0019

1114 N Main St
Ste A
Shelbyville, TN 37160
Phone (931) 652-9369

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22116/brand/1/csg/1/fhir/r4

Organizations & group practices 12

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.

Hospital & facility affiliations 9

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1730566175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 N MAIN ST STE A",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602380",
            "telephone_number": "931-365-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 N MAIN ST STE A",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602380",
            "telephone_number": "931-365-2149",
            "fax_number": "931-492-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JOHN",
        "middle_name": "MASON",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-06",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, TN

Sources for this page

Verify at the official NPI Registry.