Individual provider Active NPI

Chelsea Boston Tehan, MD

  • Pediatrics Physician
  • Adairsville, GA
National Provider Identifier
1154554392
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
74113 Issued in GA
Practice address
115 N Central Ave
Adairsville, GA 30103-2467
Phone
(470) 601-5750
Fax
(770) 877-3655
NPI assigned
Sep 3, 2009
Last updated
Aug 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 74113 GA Primary

Addresses

Primary practice location

115 N Central Ave
Adairsville, GA 30103-2467

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1038

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chelsea.tehan.1@1498.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210429000319 GA Practitioner - Pediatric Medicine 7315193901 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC Current Accepting new patients
Harbin Clinic, LLC CurrentSince Jul 31, 2021 Accepting new patients
Southeast Regional Primary Care Corporation Current Accepting new patients
Harbin Clinic, LLC CurrentSince Jul 31, 2021 Accepting new patients
Vidalia Children's Center LLC Pediatrics Current Accepting new patients
Floyd Healthcare Management Inc Past Accepting new patients
Floyd Healthcare Management Inc Past Accepting new patients

Locations

115 N Central Ave
Adairsville, GA 30103
Phone (470) 601-5650

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

125 Church St
Vidalia, GA 30474
Phone (912) 538-8484

Interoperability endpoints

  • Direct secure messaging: chelsea.tehan.1@1498.direct.athenahealth.com
  • Direct secure messaging: chelsea.tehan@srpcc.gadirect.net
  • Direct secure messaging: chelsea.tehan@vcc.gadirect.net
  • Direct secure messaging: ctehan913086@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1154554392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N CENTRAL AVE",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "301032467",
            "telephone_number": "470-601-5750",
            "fax_number": "770-877-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEHAN",
        "first_name": "CHELSEA",
        "middle_name": "BOSTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "74113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chelsea.tehan.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "115 N Central Ave",
            "city": "Adairsville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301032467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Adairsville, GA

Sources for this page

Verify at the official NPI Registry.