The section of Old Hickory Boulevard south of Hermitage to Antioch was interrupted by the creation of Percy Priest Lake and is now partially underwater.

The two are distinct, however, as traffic continues from Old Hickory Boulevard straight onto Bell Road along SR 254 at an intersection about 0.6 miles (0.97 km) east of Nolensville Pike (US 31A/US 41A).

This is just south of the Cumberland River, approximately 2.3 miles (3.7 km) southwest of the end of the northern segment at Cleeces Ferry.

From there, it traverses northward as a two-lane road through Bells Bend before intersecting Ashland City Highway (SR 12) in the Scottsboro area.

Continuing northward, the route passes through the slightly rugged terrain of northwest Davidson County, intersecting Eatons Creek Road near Beaman Park and Clarksville Pike (US 41A) shortly afterward.

After serving as the southern terminus of Lickton Pike at Whites Creek High School, the road briefly becomes four-laned at the I-24 interchange.

It continues due east as a two-lane road along its original alignment through Madison before the designation jumps back to the adjacent SR 45 at the bridge across the Cumberland River.

Becoming two-laned again, it intersects Bell Road near Nashville Shores, then continues 400 yards (370 m) south to a boat ramp on Percy Priest Lake.

The creation of Percy Priest Lake interrupted the southeast portion of the highway, leaving a disjointed segment and eliminating approximately six miles (9.7 km) of the route.

This resulted in Old Hickory Boulevard seemingly shifting a block south of SR 45 between Gallatin Pike (US 31E) and the Cumberland River, as the designation continues to follow the original alignment.