Individual provider Active NPI

Michael G Carr, M.D.

  • Pediatric Surgery Physician
  • Chattanooga, TN
National Provider Identifier
1083608707
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
MD13707 Issued in TN
Practice address
979 E 3Rd St
Ste 300
Chattanooga, TN 37403-2136
Phone
(423) 267-0466
Fax
(423) 757-0775
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD13707 TN
Pediatric Surgery Physician 2086S0120X MD13707 TN Primary
Surgery Physician 208600000X MD13707 TN

Addresses

Primary practice location

979 E 3Rd St
Ste 300
Chattanooga, TN 37403-2136

Mailing address

979 E 3Rd St
Ste 300
Chattanooga, TN 37403-2136
Phone (423) 267-0466

Other identifiers 10

IdentifierTypeStateIssuer
00334661AMedicaidGA
1740071OtherUHC
3001093MedicaidTN
3250177 001OtherCIGNA
890524NMedicaidNC
020029188OtherRR MEDICARE
009933940MedicaidAL
62165877419OtherJDH
2231042MedicaidOH
27871OtherBCBS OF TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD13707TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgical Associates PC Surgery Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71772

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1083608707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST",
            "address_2": "STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032136",
            "telephone_number": "423-267-0466",
            "fax_number": "423-757-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST",
            "address_2": "STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032136",
            "telephone_number": "423-267-0466",
            "fax_number": "423-757-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD13707",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TN",
            "license": "MD13707",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD13707",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00334661A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1740071",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001093",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3250177 001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890524N",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "020029188",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933940",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JDH",
            "identifier": "62165877419",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2231042",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "27871",
            "state": null
        }
    ],
    "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 Feb 11, 2015; 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.