=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811077712
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BENJAMIN EDGAR SHOEMAKER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2006
-----------------------------------------------------
Last Update Date | 11/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 302 N MAIN ST
-----------------------------------------------------
City | ASHLAND CITY
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37015-1306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-792-2280
-----------------------------------------------------
Fax | 615-412-2053
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 429
-----------------------------------------------------
City | ASHLAND CITY
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37015-0429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-792-2280
-----------------------------------------------------
Fax | 615-792-1261
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number | MD18084
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD18084
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------