MEDICARE: JENNIFER M EVERETT - DAMEWOOD D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	P5625	TX
2	207R00000X	Internal Medicine Physician	0116022872	VA
3	208M00000X	Hospitalist Physician	3484	TN
4	207R00000X	Internal Medicine Physician	3484	TN

General Provider Information

NPI Number	:	1467764639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER M EVERETT - DAMEWOOD D.O.

Provider Business Mailing Address
First Line	:	355 NEW SHACKLE ISLAND RD
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-2479
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 NEW SHACKLE ISLAND RD
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-2479
Country	:	US
Telephone Number	:	615-338-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2010
Last Update Date	:	12/05/2025

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