Vlatka Agnetta, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

61320 Issued in TN

Practice address

2358 Lifestyle Way Ste 212
Chattanooga, TN 37421-4904

Phone

(423) 521-1100

Fax

(423) 521-1200

NPI assigned

Apr 25, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA, TN, GA3 enrollments

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 3

Specialty

DermatologyAlso: Emergency Medicine

Education

Loma Linda University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Specialists PLLC 8 clinicians

Tennessee River Physicians, PLLC 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Dermatology Specialists PLLC

  • Dermatology Physician
  • Powell, TN
  • NPI 1770641268

  Dermatology, TN

  Medicare reassignment Care Compare group NPD
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1396282463

  Emergency Medicine, TN

  Medicare reassignment Care Compare group NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542

  CA, Emergency Medicine

  Medicare reassignment NPD
• Riverside Medical Clinic, Inc

  • Dermatology Physician
  • Riverside, CA
  • NPI 1720183403

  CA, Dermatology

  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  Emergency Medicine, TN

  Medicare reassignment NPD
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Dunlap, TN
  • NPI 1699212761

  Emergency Medicine

  NPD
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1710424882

  Emergency Medicine

  NPD
• Cep America - California

  • Emergency Medicine Physician
  • Moreno Valley, CA
  • NPI 1235510264

  Emergency Medicine

  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848

  Emergency Medicine

  NPD
• Riverside Medical Clinic, Inc

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1730180415

  Dermatology

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Erlanger Health

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1861194086

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1053602128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 BATTLEFIELD CROSSING CT",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307365176",
            "telephone_number": "706-277-7311",
            "fax_number": "706-529-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2358 LIFESTYLE WAY STE 212",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214904",
            "telephone_number": "423-521-1100",
            "fax_number": "423-521-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNETTA",
        "first_name": "VLATKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "86364",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A122120",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME140586",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "61320",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A122120",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TN",
            "license": "61320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer & Cosmetic Dermatology Center, PC",
            "address_1": "1107 Memorial Drive",
            "address_2": "Suite 201",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer & Cosmetic Dermatology Center, PC",
            "address_1": "2253 Chambliss Ave NW",
            "address_2": "Suite 202",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373113861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Agilitas USA, Inc
• Agilitas USA, Inc
• Agilitas USA, Inc
• Agilitas USA, Inc.
• Aging Care Solutions, LLC
• Jessica L Agnew, APRN
• Ifeoma Aguanunu, M.D.
• Afrodita Aguilar, NP
• Danya Ahmed, MD
• Meagan Aiken-Vaphiadis, M.D.

• All providers in Chattanooga, TN
• MOHS-Micrographic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.