Active NPI
Eric D Schubert, MD
- Anatomic Pathology & Clinical Pathology Physician
- Chattanooga, TN
National Provider Identifier
1124080304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- MD00030034
- Practice address
- 2525 Desales Avenue
Pathology Laboratory
Chattanooga, TN 37404 - Phone
- (423) 495-8703
- Fax
- (423) 495-6175
- NPI assigned
- Apr 4, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MD00030034 | TN | Primary |
Addresses
Primary practice location
2525 Desales Avenue
Pathology Laboratory
Chattanooga, TN 37404
Mailing address
PO Box 3637
Attn Judy Nowlin
Chattanooga, TN 37404
Phone (423) 629-7688
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3819593 | Medicaid | 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 |
|---|---|---|---|
| MD00030034 | TN | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190937600000",
"number": "1124080304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3637",
"address_2": "ATTN JUDY NOWLIN",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "37404",
"telephone_number": "423-629-7688",
"fax_number": "423-495-6175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 DESALES AVENUE",
"address_2": "PATHOLOGY LABORATORY",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "37404",
"telephone_number": "423-495-8703",
"fax_number": "423-495-6175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHUBERT",
"first_name": "ERIC",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-04",
"last_updated": "2007-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "TN",
"license": "MD00030034",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3819593",
"state": "TN"
}
],
"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 Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.