Active NPI
Michael G Carr, M.D.
- Pediatric Surgery Physician
- Chattanooga, TN
National Provider Identifier
1083608707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- MD13707
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00334661A | Medicaid | GA | |
| 1740071 | Other | UHC | |
| 3001093 | Medicaid | TN | |
| 3250177 001 | Other | CIGNA | |
| 890524N | Medicaid | NC | |
| 020029188 | Other | RR MEDICARE | |
| 009933940 | Medicaid | AL | |
| 62165877419 | Other | JDH | |
| 2231042 | Medicaid | OH | |
| 27871 | Other | BCBS 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
| License | State | Type | Specialty |
|---|---|---|---|
| MD13707 | TN | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Surgical Associates PC | Surgery | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Surgery Physician
- Chattanooga, TN
- NPI 1437102704
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.