NPIMap

Individual provider Active NPI

Shanita Poindexter, NP

  • Family Nurse Practitioner
  • Thompsons Station, TN
National Provider Identifier
1760126171
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33967 Issued in TN
Practice address
4805 Columbia Pike
Thompsons Station, TN 37179-5207
Phone
(615) 791-0974
NPI assigned
Apr 21, 2022
Last updated
Jul 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5016094 NC
Family Nurse Practitioner 363LF0000X 33967 TN Primary

Addresses

Primary practice location

4805 Columbia Pike
Thompsons Station, TN 37179-5207

Mailing address

4805 Columbia Pike
Thompsons Station, TN 37179-5207
Phone (615) 791-0974

Other names 1

  • Shanita Jones Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230828000230 TN Practitioner - Nurse Practitioner 0042690299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iris Medical GroupGroup PAC ID 0648653360, 82 clinicians

Practice addresses (Care Compare)

9019 Overlook Blvd
Suite C1B
Brentwood, TN 37027-2737
Phone (615) 274-9767

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.14 of 100Reported as group
Quality
83.39
Improvement activities
40
Cost
80.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33967TNMDPsychiatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Iris Medical Group Family CurrentSince Apr 7, 2024 Accepting new patients
Iris Wound Care, PC Past Accepting new patients

Locations

9019 Overlook Blvd
Ste C1B
Brentwood, TN 37027
Phone (769) 333-8808

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: shanita.poindexter.1@30029.direct.athenahealth.com

Organizations & group practices 2

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": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1760126171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 COLUMBIA PIKE",
            "city": "THOMPSONS STATION",
            "state": "TN",
            "postal_code": "371795207",
            "telephone_number": "615-791-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 COLUMBIA PIKE",
            "city": "THOMPSONS STATION",
            "state": "TN",
            "postal_code": "371795207",
            "telephone_number": "615-791-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POINDEXTER",
        "first_name": "SHANITA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016094",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "33967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANITA",
            "last_name": "JONES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thompsons Station, TN

Sources for this page

Verify at the official NPI Registry.