Individual provider Active NPI

James Robert Headrick Jr., MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Chattanooga, TN
National Provider Identifier
1104812817
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
24097 Issued in TN
Practice address
605 Glenwood Drive, Suite 105
CHI Memorial Thoracic Oncology Associates
Chattanooga, TN 37404
Phone
(423) 495-5864
Fax
(423) 495-2065
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 24097 TN Primary

Addresses

Primary practice location

605 Glenwood Drive, Suite 105
CHI Memorial Thoracic Oncology Associates
Chattanooga, TN 37404

Mailing address

1949 Gunbarrel Road
Suite 230
Chattanooga, TN 37421
Phone (423) 495-4349

Other identifiers 1

IdentifierTypeStateIssuer
3073584MedicaidTN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080326000284 TN Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 5496658445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
University of Tennessee, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Health Partners Foundation IncGroup PAC ID 8022919570, 458 clinicians

Practice addresses (Care Compare)

605 Glenwood Dr
Suite 105
Chattanooga, TN 37404-1151
Phone (423) 495-2555

Hospital & facility affiliations

  • Commonspirit Health at Home - Chattanooga Home health agency, Chattanooga, TN, CCN 447506
  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091
  • Parkridge Medical Center Hospital, Chattanooga, TN, CCN 440156
  • Affiliate of Vitruvian Health Hospital, Cleveland, TN, CCN 440185
  • Rhea Medical Center Hospital, Dayton, TN, CCN 441310

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24097TNMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation, Inc CurrentSince Aug 1, 2017 Accepting new patients
Memorial Health Partners Foundation Inc Current Accepting new patients
Memorial Health Partners Foundation Inc CurrentSince Aug 1, 2017 Accepting new patients
Memorial Health Care System Inc. Past Accepting new patients

Locations

2501 Citico Ave
Fl 3
Chattanooga, TN 37404
Phone (423) 629-6550

1949 Gunbarrel Rd
Ste 206
Chattanooga, TN 37421
Phone (423) 495-4345

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

605 Glenwood Dr
Ste 105
Chattanooga, TN 37404
Phone (423) 495-3304

2108 E 3rd St
Ste 300
Chattanooga, TN 37404
Phone (423) 624-5200

2501 Citico Ave
Chattanooga, TN 37404
Phone (423) 697-2318

Interoperability endpoints

  • Direct secure messaging: jamesheadrick@tnmhpf.allscriptsdirect.net
  • Direct secure messaging: jheadrick133452@direct.stlukeshealth.org

Organizations & group practices 4

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 6

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104812817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 GUNBARREL ROAD",
            "address_2": "SUITE 230",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-495-4349",
            "fax_number": "423-495-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 GLENWOOD DRIVE, SUITE 105",
            "address_2": "CHI MEMORIAL THORACIC ONCOLOGY ASSOCIATES",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-495-5864",
            "fax_number": "423-495-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADRICK",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TN",
            "license": "24097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3073584",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.