Individual provider Active NPI

Blaire Chandler Terrell

  • Medical Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1073349593
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2525 Desales Ave
Chattanooga, TN 37404-1161
Phone
(423) 495-2525
NPI assigned
Sep 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

2525 Desales Ave
Chattanooga, TN 37404-1161

Mailing address

1450 Everhart Dr NW
Cleveland, TN 37311-4127

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241220001173 TN Practitioner - Physician Assistant 4789111394 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 492-4734

5600 Brainerd Rd
Suite 500
Chattanooga, TN 37411-5371
Phone (423) 414-3586

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation, Inc CurrentSince Nov 11, 2024 Accepting new patients
Memorial Health Partners Foundation Inc CurrentSince Nov 11, 2024 Accepting new patients

Locations

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1073349593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 EVERHART DR NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373114127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-495-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "BLAIRE",
        "middle_name": "CHANDLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.