Individual provider Active NPI

Thomas M Reynolds, M.D.

  • Ophthalmology Physician
  • Chattanooga, TN
National Provider Identifier
1003815580
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD016274 Issued in TN
Practice address
2158 Northgate Park LN
Suite 302
Chattanooga, TN 37415-6957
Phone
(423) 870-4900
Fax
(423) 870-5889
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD016274 TN Primary

Addresses

Primary practice location

2158 Northgate Park LN
Suite 302
Chattanooga, TN 37415-6957

Mailing address

2158 Northgate Park LN
Suite 302
Chattanooga, TN 37415-6957
Phone (423) 870-4900

Other identifiers 6

IdentifierTypeStateIssuer
180029644OtherRR MEDICARE
3711088MedicaidTN
3031931MedicaidTN
1187690001OtherSCDMERC GROUP SUPPLIER NUMB
3069497OtherBLUE CROSS
62-1701871OtherTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050131000863 TN Practitioner - Ophthalmology 4981689080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Tennessee, HSC, College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chattanooga Vision Center, PLCGroup PAC ID 1456336551, 4 clinicians

Practice addresses (Care Compare)

2158 Northgate Park Lane
Suite 302
Chattanooga, TN 37415-6959
Phone (423) 870-4900

2158 Northgate Park LN
Suite 302
Chattanooga, TN 37415-6959

Merit-based Incentive Payment System (MIPS)

Final score
93.56 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.53

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD016274TNMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Vision Center, PLC Ophthalmology CurrentSince Oct 1, 1997 Accepting new patients

Locations

2158 Northgate Park Ln
Ste 302
Chattanooga, TN 37415
Phone (423) 870-4900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1003815580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 NORTHGATE PARK LN",
            "address_2": "SUITE 302",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374156957",
            "telephone_number": "423-870-4900",
            "fax_number": "423-870-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 NORTHGATE PARK LN",
            "address_2": "SUITE 302",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374156957",
            "telephone_number": "423-870-4900",
            "fax_number": "423-870-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD016274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "180029644",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3711088",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3031931",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC GROUP SUPPLIER NUMB",
            "identifier": "1187690001",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3069497",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "62-1701871",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.