Individual provider Active NPI

Mark Cloutier

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1124476007
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21249 Issued in TN
Practice address
1809 Gunbarrel Rd
Chattanooga, TN 37421-7185
Phone
(429) 893-9020
NPI assigned
Jun 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21249 TN Primary

Addresses

Primary practice location

1809 Gunbarrel Rd
Chattanooga, TN 37421-7185

Mailing address

1809 Gunbarrel Rd
Chattanooga, TN 37421-7185

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
I20160711001620 TN Practitioner - Nurse Practitioner 2860784964 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger Health 504 clinicians

Practice addresses (Care Compare)

1809 Gunbarrel Rd
Chattanooga, TN 37421-7185

2600 Taft Hwy
Suite 100
Signal Mountain, TN 37377-2777
Phone (423) 778-9434

Hospital & facility affiliations

  • Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jun 1, 2016 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jun 1, 2016 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients

Locations

1809 Gunbarrel Rd
Chattanooga, TN 37421
Phone (423) 348-0698

1809 Gunbarrel Rd
Ste 101
Chattanooga, TN 37421
Phone (423) 648-0698

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

1100 E 3rd St
Ste G102
Chattanooga, TN 37403
Phone (423) 778-6784

4312 Holiday Inn Express Way NW
Ste 103
Cleveland, TN 37312
Phone (423) 778-9612

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Interoperability endpoints

  • Direct secure messaging: mark.cloutier.1@2651.direct.athenahealth.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1124476007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 GUNBARREL RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 GUNBARREL RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217185",
            "telephone_number": "429-893-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.