Active NPI
Sandip R Shukla, MD
- Psychiatry Physician
- Tullahoma, TN
National Provider Identifier
1972596716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD10653
- Practice address
- 107 E Grundy St
Tullahoma, TN 37388-3613 - Phone
- (931) 455-2616
- Fax
- (931) 455-2280
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD10653 | TN | Primary |
Addresses
Primary practice location
107 E Grundy St
Tullahoma, TN 37388-3613
Mailing address
107 E Grundy St
Tullahoma, TN 37388-3613
Phone (931) 455-2616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3163913 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD10653 | TN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shull Chiropractic Clinic PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Winchester, TN
- NPI 1194921510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1972596716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 E GRUNDY ST",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "373883613",
"telephone_number": "931-455-2616",
"fax_number": "931-455-2280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 E GRUNDY ST",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "373883613",
"telephone_number": "931-455-2616",
"fax_number": "931-455-2280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUKLA",
"first_name": "SANDIP",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TN",
"license": "MD10653",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3163913",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tullahoma, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.