In Charge Medical Professionals TN,PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

IN CHARGE MEDICAL PROFESSIONALS TN,PC

Practice address

709 Walnut St
Chattanooga, TN 37402

Phone

(414) 312-5159

Fax

(888) 724-0875

NPI assigned

Jul 10, 2017

Last updated

Sep 11, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

IN CHARGE MEDICAL PROFESSIONALS LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Jodi CzernejewskiNPI 1982969812

Title

Coo

Phone

(262) 510-6350

Specialties & licenses 2

Addresses

Other identifiers 4

Part of

In Charge Medical Professionals LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• In Charge Medical Professionals LLC

  • Internal Medicine Physician
  • Peachtree City, GA
  • NPI 1124426606

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jodi M Czernejewski

  • Speech-Language Pathologist
  • Milwaukee, WI
  • NPI 1982969812
  Authorized official Same address or phone

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1265954424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 W LAYTON AVE STE 106",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212600",
            "telephone_number": "414-242-5468",
            "fax_number": "888-724-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 WALNUT ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37402",
            "telephone_number": "414-312-5159",
            "fax_number": "888-724-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN CHARGE MEDICAL PROFESSIONALS TN,PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IN CHARGE MEDICAL PROFESSIONALS LLC",
        "enumeration_date": "2017-07-10",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "CZERNEJEWSKI",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "262-510-6350",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300015508",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300014452",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300015507",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300015506",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.