Individual provider Active NPI

Jeffrey Durant Clinkscales, M.D.

  • Emergency Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1053604165
Registry record updated Sep 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
49552 Issued in TN
Practice address
975 E 3Rd St
Chattanooga, TN 37403-2147
Phone
(423) 778-7628
NPI assigned
May 23, 2011
Last updated
Sep 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD36625 SC
Emergency Medicine Physician 207P00000X 49552 TN Primary

Addresses

Primary practice location

975 E 3Rd St
Chattanooga, TN 37403-2147

Mailing address

1770 Urban TRL Apt 102
Chattanooga, TN 37405-1542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20130617000281 TN Practitioner - Emergency Medicine 0648416164 Reassigns benefits to 3 organizations
I20181217001394 GA Practitioner - Emergency Medicine 0648416164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical University of South Carolina College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tennessee River Physicians, PLLCGroup PAC ID 8022387349, 65 clinicians

Practice addresses (Care Compare)

975 E 3Rd St
Chattanooga, TN 37403-2173
Phone (423) 778-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD36625SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee River Physicians, PLLC Emergency Medicine Current Accepting new patients
Tennessee River Physicians, PLLC Emergency Medicine CurrentSince Aug 19, 2017 Accepting new patients
Emergency Medicine Services of TN, PC Emergency Medicine CurrentSince Jan 8, 2024 Accepting new patients
Putnam Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 6, 2023 Accepting new patients
Tennessee Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Tennessee Em-I Medical Services PC Past Accepting new patients
Emergency Physicians PC Emergency Medicine Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

483 Camp Jordan Pkwy
East Ridge, TN 37412
Phone (423) 242-6880

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

Interoperability endpoints

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

Organizations & group practices 8

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504224000000",
    "number": "1053604165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 URBAN TRL APT 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374051542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINKSCALES",
        "first_name": "JEFFREY",
        "middle_name": "DURANT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-23",
        "last_updated": "2017-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "MD36625",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "49552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.