Organization Active NPI

Chattanooga Family Practice Associates, P.C.

  • Family Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1124132634
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CHATTANOOGA FAMILY PRACTICE ASSOCIATES, P.C.
Practice address
961 Spring Creek Rd
Chattanooga, TN 37412-3909
Phone
(423) 892-2221
Fax
(423) 490-3407
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Dr. David Kendall Close, M.D.NPI 1558335844
Title
Medical Director
Phone
(423) 892-2221

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

961 Spring Creek Rd
Chattanooga, TN 37412-3909

Mailing address

961 Spring Creek Rd
Chattanooga, TN 37412-3909
Phone (423) 892-2221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061113000254 TN Part B Supplier - Clinic/Group Practice 9830197540 Receives reassigned benefits from 14 practitioners
Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1124132634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 SPRING CREEK RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123909",
            "telephone_number": "423-892-2221",
            "fax_number": "423-490-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 SPRING CREEK RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123909",
            "telephone_number": "423-892-2221",
            "fax_number": "423-490-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTANOOGA FAMILY PRACTICE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "CLOSE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "KENDALL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "423-892-2221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "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 Mar 5, 2024; 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.