Individual provider Active NPI

Antonio Maria Lazcano Jr., APN

  • Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1235642380
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23581 Issued in TN
Practice address
975 E 3Rd St
Chattanooga, TN 37403-2147
Phone
(423) 778-7000
NPI assigned
Nov 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 23581 TN
Nurse Practitioner 363L00000X 23581 TN Primary

Addresses

Primary practice location

975 E 3Rd St
Chattanooga, TN 37403-2147

Mailing address

975 E 3Rd St
Chattanooga, TN 37403-2147

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180521000057 TN Practitioner - Nurse Practitioner 1456616564 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

979 E 3Rd St
Suite C735
Chattanooga, TN 37403-3310
Phone (423) 778-9101

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23581TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jan 1, 2018 Accepting new patients
Southeastern Physician Services PC Nurse Practitioner CurrentSince Aug 7, 2023 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
App of Tennessee HM, PLLC Nurse Practitioner CurrentSince Mar 9, 2023 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jan 1, 2018 Accepting new patients

Locations

1114 W Madison Ave
Athens, TN 37303
Phone (423) 744-3256

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

979 E 3rd St
Ste C735
Chattanooga, TN 37403
Phone (423) 778-9101

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • Direct secure messaging: antonio.lazcano@hca1.eclinicaldirectplus.com

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1510444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1235642380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZCANO",
        "first_name": "ANTONIO",
        "middle_name": "MARIA",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-12",
        "last_updated": "2022-04-07",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "23581",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "23581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.