Organization Active NPI

Scenic City Podiatry, PLLC

  • Podiatrist
  • Chattanooga, TN
National Provider Identifier
1093911422
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SCENIC CITY PODIATRY, PLLC
Practice address
1510 Gunbarrel Rd
Suite 300
Chattanooga, TN 37421-7174
Phone
(423) 499-6488
Fax
(423) 855-4100
NPI assigned
Jun 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Authorized official

Name
Dr. Loyd William Witherspoon Jr., DPMNPI 1568526051
Title
Owner
Phone
(423) 499-6488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1510 Gunbarrel Rd
Suite 300
Chattanooga, TN 37421-7174

Mailing address

1510 Gunbarrel Rd
Suite 300
Chattanooga, TN 37421-7174
Phone (423) 499-6488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071207000748 TN Part B Supplier - Clinic/Group Practice 4183713555 Receives reassigned benefits from 1 practitioner
Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory

Locations

5000 W Esplanade Ave
Metairie, LA 70006
Phone (504) 344-1945

1720 Gunbarrel Rd
Ste 104
Chattanooga, TN 37421
Phone (423) 490-1547

1510 Gunbarrel Rd
Ste 300
Chattanooga, TN 37421
Phone (423) 499-6488

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1093911422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 GUNBARREL RD",
            "address_2": "SUITE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217174",
            "telephone_number": "423-499-6488",
            "fax_number": "423-855-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 GUNBARREL RD",
            "address_2": "SUITE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217174",
            "telephone_number": "423-499-6488",
            "fax_number": "423-855-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCENIC CITY PODIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "WITHERSPOON",
        "authorized_official_first_name": "LOYD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-499-6488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.