SHAVETTA D CONNER (MD) – Public Health & General Preventive Medicine Physician, NPI 1235283623
Public Health & General Preventive Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
23 PREVENTIVE MEDICINE in TN
Provider Addresses for SHAVETTA D CONNER (MD)
295 SUMMAR AVE
JACKSON, TN 38301
Phone: (731) 421-6703
Fax: (731) 935-7093
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $119.
Total Amount is formed as General ($119) + Research ($0) + Ownership ($0) = $119.
Last reported payment date: 2023-11-14 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($119).
Total Amount
$119
General + Research + Ownership
Payments
1
Total payment records
General Amount
$119
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $119 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-01-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20151210001393 | I | Infectious Disease | TN | TBD |
| I20260104000215 | I | Preventive Medicine | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 72 | 43 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 68 | 43 | $0 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 11 | 11 | $0 |
Insurance plans in this area (ZIP 38301)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INFECTIOUS DISEASE | TN | 90670 | Pneumococcal vaccine for injection into muscle | 43 | 43 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TN | |
| Physical Therapist In Private Practice | TN | |
| P S Y C H I A T R Y | TN | |
| Physical Therapist In Private Practice | TN | |
| P S Y C H I A T R Y | TN | |
| - | NH | |
| P S Y C H I A T R Y | TN | |
| Nurse Practitioner | TN | |
| Internal Medicine | TN | |
| - | TN |
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