NPIMap

Organization Active NPI

Orange Grove Center Inc

  • Physical Therapist
  • Chattanooga, TN
National Provider Identifier
1225199888
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
00000065 Issued in TN
Legal business name
ORANGE GROVE CENTER INC
Practice address
615 Derby St
Chattanooga, TN 37404-1632
Phone
(423) 629-1451
Fax
(423) 493-2950
NPI assigned
Dec 13, 2006
Organization subpart
Yes
Parent organization
ORANGE GROVE CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Ms. Tera Roberts
Title
Ceo
Phone
(423) 493-2910

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 00000065 TN Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 00000065 TN
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 00000065 TN

Addresses

Primary practice location

615 Derby St
Chattanooga, TN 37404-1632

Mailing address

615 Derby St
Attention: Health Informatics & Reimbursement
Chattanooga, TN 37404-1632
Phone (423) 493-2906

Other identifiers 1

IdentifierTypeStateIssuer
1531219MedicaidTN

Other names 1

  • Orange Grove Center Therapy Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000610 TN Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 1850299124 Practice locations: Chattanooga, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Orange Grove Center Inc 5345 Mountain Creek22 organizations share this tax ID, including this one
Part of
Orange Grove Center Inc 5345 Mountain Creek

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1225199888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 DERBY ST",
            "address_2": "ATTENTION: HEALTH INFORMATICS & REIMBURSEMENT",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041632",
            "telephone_number": "423-493-2906",
            "fax_number": "423-493-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 DERBY ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041632",
            "telephone_number": "423-629-1451",
            "fax_number": "423-493-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE GROVE CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORANGE GROVE CENTER INC",
        "enumeration_date": "2006-12-13",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "TERA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-493-2910",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "00000065",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "00000065",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "00000065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1531219",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange Grove Center Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 4, 2024; 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.