Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Dr. Peter Shi, DO

Individual provider Internal Medicine Physician · NPI 1336569904

Dr. Peter Shi, DO practises Internal Medicine in Jackson, Tennessee. Graduated from New York College of Osteo Medicine of New York Institute of Technology in 2014, 12 years ago. Practices with Sebastian Physician Services, PLLC, a 41-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and Tennessee.

Years since qualifying
12
Trained at
New York College of Osteo Medicine of New York Institute of Technology
Licensed in
IN, TN
In the registry since
2014
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

620 Skyline Dr
Jackson, TN 38301-3923
Phone: (731) 541-4923
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 — (260) 266-2020

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 02005562A (IN)
Internal Medicine Physician Taxonomy 207R00000X · Licence 3196 (TN)

Record details

NPI number1336569904
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 22, 2014
Last updated in NPPESOctober 15, 2022
Certification dateOctober 15, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolNEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated 2014 (12 years in practice)
Group practice Sebastian Physician Services, Pllc — 41 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients515
Services billed 1,119 a service is one billed item, such as a visit, a test or a procedure
Average patient age77

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Sebastian Physician Services, PLLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 41 clinicians in the practice; 12 are shown here.

Other providers in Jackson