Individual provider Active NPI

Mary C Hammock, MD

  • Internal Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1174509640
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14192 Issued in TN
Practice address
725 Glenwood Dr
Suite 480
Chattanooga, TN 37404-1163
Phone
(423) 756-5779
Fax
(423) 242-4552
NPI assigned
Dec 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14192 TN Primary

Addresses

Primary practice location

725 Glenwood Dr
Suite 480
Chattanooga, TN 37404-1163

Mailing address

725 Glenwood Dr
Suite 480
Chattanooga, TN 37404-1163
Phone (423) 756-5779

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
I20100818000263 TN Practitioner - Internal Medicine 7113003856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

800 College Pkwy
Lewisville, TX 75077-3503
Phone (972) 420-8543

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14192TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Health Alliance PC Internal Medicine CurrentSince Jul 1, 1998 Accepting new patients

Locations

725 Glenwood Dr
Ste E480
Chattanooga, TN 37404
Phone (423) 629-1491

632 Morrison Springs Rd
Ste 101
Chattanooga, TN 37415
Phone (423) 778-3348

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1174509640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "SUITE 480",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-756-5779",
            "fax_number": "423-242-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "SUITE 480",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-756-5779",
            "fax_number": "423-242-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOCK",
        "first_name": "MARY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "14192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.