Individual provider Active NPI

Molly R Seal, M.D.

  • Ophthalmology Physician
  • Chattanooga, TN
National Provider Identifier
1144227281
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD006421 Issued in TN
Practice address
1042 E 3Rd St
Ste 102
Chattanooga, TN 37403-2167
Phone
(423) 265-1651
Fax
(423) 756-0050
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD006421 TN Primary

Addresses

Primary practice location

1042 E 3Rd St
Ste 102
Chattanooga, TN 37403-2167

Mailing address

1042 E 3Rd St
Ste 102
Chattanooga, TN 37403-2167
Phone (423) 265-1651

Other identifiers 2

IdentifierTypeStateIssuer
3141160MedicaidTN
00563618MedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000206 TN Practitioner - Ophthalmology 1153394739

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD006421TNMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1144227281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 E 3RD ST",
            "address_2": "STE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032167",
            "telephone_number": "423-265-1651",
            "fax_number": "423-756-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 E 3RD ST",
            "address_2": "STE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032167",
            "telephone_number": "423-265-1651",
            "fax_number": "423-756-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAL",
        "first_name": "MOLLY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD006421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3141160",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00563618",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.