Organization Active NPI

Tri-State Gastroenterology Associates, PLLC

  • Gastroenterology Physician
  • Chattanooga, TN
National Provider Identifier
1063802734
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
36425 Issued in TN
Legal business name
TRI-STATE GASTROENTEROLOGY ASSOCIATES, PLLC
Practice address
935 Spring Creek Rd
Suite 203
Chattanooga, TN 37412-3993
Phone
(423) 760-4360
Fax
(423) 760-4361
NPI assigned
Feb 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Dr. Nikhil S Shah, MD
Title
Owner
Phone
(931) 284-9660

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 36425 TN Primary
Gastroenterology Physician 207RG0100X
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

935 Spring Creek Rd
Suite 203
Chattanooga, TN 37412-3993

Mailing address

2106 Ooltewah Ringgold Rd
Ooltewah, TN 37363-9345
Phone (931) 284-9660

National Provider Directory

National Provider Directory

Locations

935 Spring Creek Rd
Ste 203
Chattanooga, TN 37412
Phone (423) 760-4360

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10866/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1063802734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 OOLTEWAH RINGGOLD RD",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373639345",
            "telephone_number": "931-284-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 SPRING CREEK RD",
            "address_2": "SUITE 203",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123993",
            "telephone_number": "423-760-4360",
            "fax_number": "423-760-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE GASTROENTEROLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "NIKHIL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-284-9660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "36425",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.