Providers
JOSEPH HOWARD RUPARD, M D
NPI 1861451338, individual, Shelbyville, TN, Family Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 5 months, but with up to 1099 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99307 ($77 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7670, $2.2M at stake
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 | More hours than a day holds, even counting one unit per claim line | 24.3 | 51.1 | 34.1 | 45.9 | 1099 | 4 | 99212 99213 99214 99215 99307 99308 99309 | $69K |
| Apr 2018 | More hours than a day holds, even counting one unit per claim line | 25.8 | 33.9 | 22.6 | 32.3 | 955 | 3 | 99213 99214 99215 99307 99308 | $51K |
| May 2018 | More hours than a day holds, even counting one unit per claim line | 24.5 | 32.1 | 21.4 | 28.9 | 974 | 3 | 99213 99214 99215 99307 | $50K |
| Jul 2018 | More hours than a day holds, even counting one unit per claim line | 24.3 | 30.1 | 20.1 | 28.3 | 993 | 3 | 99213 99214 99215 99307 99308 | $46K |
| Aug 2018 | More hours than a day holds, even counting one unit per claim line | 26.0 | 30.1 | 20.1 | 27.0 | 1019 | 3 | 99213 99214 99215 99305 99307 99308 | $48K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JOSEPH HOWARD RUPARD, M D (also HOWARD RUPARD) |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | March 22, 2006, last updated May 10, 2016 |
| Practice location | 883 UNION STREET, Shelbyville, TN 37160-3108, 931-685-1145 |
| Mailing address | 883 UNION ST, Shelbyville, TN 37160-2607 |
| Specialties | Family Medicine (207Q00000X, primary, license MD024783 TN) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.2M | 41% | $48 | $60 (top 5% from $133) | 34th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $801K | 27% | $36 | $44 (top 5% from $110) | 37th percentile | |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | $448K | 15% | $77 | $7.86 (top 5% from $34) | 99th percentile | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $259K | 9% | $58 | $88 (top 5% from $210) | 26th percentile | |
| H0016 | Medicaid service code | $51K | 2% | $396 | $245 (top 5% from $397) | 95th percentile | |
| 96372 | Injection of drug or substance under skin or into muscle | $39K | 1% | $11 | $12 (top 5% from $49) | 46th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $15K | 1% | $23 | $28 (top 5% from $147) | 40th percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $12K | 0% | $15 | $14 (top 5% from $58) | 53rd percentile |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 419 | 131 | $32K | $159 | $118 | 1.3x | 2.3x (90th percentile 3.8x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 391 | 153 | $21K | $115 | $82 | 1.4x | 2.2x (90th percentile 3.8x) |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 126 | 126 | $15K | $350 | $116 | 3.0x | 2.3x (90th percentile 4.1x) |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 125 | 61 | $15K | $222 | $167 | 1.3x | 2.4x (90th percentile 4.1x) |
| 99496 | Transitional care management services for problem of high complexity | 24 | 19 | $5K | $300 | $258 | 1.2x | 1.9x (90th percentile 3.1x) |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 69 | 39 | $3K | $150 | $49 | 3.0x | 2.3x (90th percentile 3.8x) |
| 36415 | Insertion of needle into vein for collection of blood sample | 264 | 155 | $2K | $15 | $8 | 1.8x | 2.0x (90th percentile 3.5x) |
| 83036 | Hemoglobin a1c level | 216 | 112 | $2K | $40 | $9 | 4.2x | 3.5x (90th percentile 6.9x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
3 providers in Bedford County, TN carry an indicator in the public record, with $13.2M at stake between them. The most common is more hours than a day holds, on 3 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | CINDY COTHRAN Shelbyville, TN, ranked 8391 | $5.5M |
|
| 4 | ANN BLANKENSHIP Shelbyville, TN, ranked 8422 | $4.7M |
|
| 4 | PETER WERNER Shelbyville, TN, ranked 8550 | $3.0M |
|
Recent enforcement in TN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementAug 10, 2026
Celina Pharmacy Owner/Two Pharmacies Agree to Pay $450,000 & Receive Ban on Handling Controlled Substances
The defendants knowingly dispensed controlled substances without valid prescriptions and outside the usual course of professional pharmacy practice, and falsely billed Medicare for prescriptions that were not medically necessary or otherwise eligible for reimbursement.
DOJSentencedJul 8, 2026
Memphis Gynecologist Sentenced to 20 Years in Prison for Adulterating Medical Devices and Health Care Fraud
Kumar used adulterated and unlabeled single-use and improperly reprocessed reusable hysteroscopy devices in more than 15,000 hysteroscopy with biopsy procedures and billed Medicare and Medicaid for the procedures.
DOJSentencedJun 24, 2026
Celina Pharmacy Owner Sentenced for Opioid Distribution/Health Care Fraud
The majority owner of two pharmacies conspired to unlawfully dispense controlled substances despite red flags of abuse and diversion, submitted false claims to Medicare Part D and TennCare, and paid patient co-payments, cash, and "Monkey Bucks" to increase prescription volume.
DOJChargedJun 23, 2026
Clarksville Physician Charged with Health Care Fraud Related to Controlled Substance Prescribing Scheme
Aquino owned and operated North Clarksville Medical Center and for more than five years prescribed medically unnecessary controlled substances, totaling more than 1.08 million pills and doses, that were not issued for a legitimate medical purpose in the usual course of professional practice, causing losses of approximately $335,621.73 to health care benefit programs.
DOJIndictedJun 23, 2026
Gordonsville Physician Indicted on Health Care Fraud and Controlled Substance Charges
Moss owned and operated Gordonsville Clinic and prescribed medically unnecessary controlled substances, totaling more than 5.6 million pills and doses over more than eight years, that were not issued for a legitimate medical purpose in the usual course of professional practice.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.