Individual provider Active NPI

Andrew Megison

  • Oral and Maxillofacial Surgery (Dentist)
  • Chattanooga, TN
National Provider Identifier
1306239603
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
11529 Issued in TN
Practice address
6015 Shallowford Rd
Chattanooga, TN 37421-1688
Phone
(423) 298-3072
NPI assigned
Mar 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 6566 LA
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 11529 TN
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 11529 TN Primary

Addresses

Primary practice location

6015 Shallowford Rd
Chattanooga, TN 37421-1688

Mailing address

6015 Shallowford Rd
Chattanooga, TN 37421-1688
Phone (423) 298-3072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210715003399 TN Practitioner - Oral Surgery 5496032716 Reassigns benefits to 1 organization
I20240617003636 GA Practitioner - Oral Surgery 5496032716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Louisiana State University School of Medicine in New Orleans, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Oral and Maxillofacial Surgery, P. C.Group PAC ID 9931009917, 5 clinicians

Practice addresses (Care Compare)

6015 Shallowford Rd
Chattanooga, TN 37421-1688
Phone (423) 893-3333

78 Alamar St
Fort Oglethorpe, GA 30742-7303
Phone (706) 858-7054

Hospital & facility affiliations

  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091
  • Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6566LAMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Oral and Maxillofacial Surgery, P. C. CurrentSince Jul 1, 2021 Accepting new patients
Charles Dunlap, DDS PastSince May 16, 2024 Accepting new patients
Professional Medical Properties, LLC PastSince Jul 1, 2021 Accepting new patients
Waco Center for Oral & Maxillofacial Surgery PLLC Oral and Maxillofacial Surgery PastSince Feb 19, 2023 Accepting new patients

Locations

78 Alamar St
Ft Oglethorpe, GA 30742
Phone (706) 858-7054

6015 Shallowford Rd
Chattanooga, TN 37421
Phone (423) 893-3333

Organizations & group practices 4

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.

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": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1306239603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211688",
            "telephone_number": "423-298-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211688",
            "telephone_number": "423-298-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEGISON",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-10",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "LA",
            "license": "6566",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11529",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "11529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.