Individual provider Active NPI

Carrie Suzanne Durante, PA-C

  • Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1114299484
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2071 Issued in TN
Practice address
2200 E 3Rd St Ste 200
Chattanooga, TN 37404-2745
Phone
(423) 643-2500
Fax
(423) 305-7822
NPI assigned
Feb 2, 2012
Sex
Female
Sole proprietor
No

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 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Medical Group, PC 122 clinicians

Practice addresses (Care Compare)

1651 Gunbarrel Rd
Chattanooga, TN 37421-3291

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 308-0280

4980 Alpha LN
Hixson, TN 37343-5470
Phone (423) 870-2450

Hospital & facility affiliations

  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

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
I20141009001684 TN Practitioner - Physician Assistant 1557520640 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6337GAMDPhysician Assistant
2071TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Medical Group PC CurrentSince Jul 24, 2022 Accepting new patients
J & a Enterprises Inc Past Accepting new patients

Locations

2200 E 3rd St
Ste 200
Chattanooga, TN 37404
Phone (423) 643-2500

4976 Alpha Ln
Hixson, TN 37343
Phone (423) 308-0280

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6337 GA
Physician Assistant 363A00000X 2071 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

2200 E 3Rd St Ste 200
Chattanooga, TN 37404-2745

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 497-5355

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 5, 2023.

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1114299484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E 3RD ST STE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374042745",
            "telephone_number": "423-643-2500",
            "fax_number": "423-305-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURANTE",
        "first_name": "CARRIE",
        "middle_name": "SUZANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-02",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6337",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.