Organization Active NPI

Chattanooga Autism Center

  • Clinical Social Worker
  • Chattanooga, TN
National Provider Identifier
1134486855
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0000004479 Issued in TN
Legal business name
CHATTANOOGA AUTISM CENTER
Practice address
3097 Broad St
Chattanooga, TN 37408-3089
Phone
(423) 260-1115
Fax
(423) 752-5299
NPI assigned
Apr 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Authorized official

Name
Mrs. Karen Lynn Weigle, PHDNPI 1821246497
Title
President
Phone
(423) 260-1115

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
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0000004479 TN Primary

Addresses

Primary practice location

3097 Broad St
Chattanooga, TN 37408-3089

Mailing address

4445 Wellesley Dr
Ooltewah, TN 37363-4887
Phone (423) 260-1115

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130102000231 TN Part B Supplier - Clinic/Group Practice 2365695236 Receives reassigned benefits from 2 practitioners
Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory

Locations

1400 McCallie Ave
Ste 100
Chattanooga, TN 37404
Phone (423) 531-6961

507 W 26th St
Ste 107
Chattanooga, TN 37408

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1134486855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 WELLESLEY DR",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373634887",
            "telephone_number": "423-260-1115",
            "fax_number": "423-752-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3097 BROAD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374083089",
            "telephone_number": "423-260-1115",
            "fax_number": "423-752-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTANOOGA AUTISM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "WEIGLE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-260-1115",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "0000004479",
            "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 Apr 19, 2012; 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.