Individual provider Active NPI

Levin Dirk Fairchild, MD

  • Student in an Organized Health Care Education/Training Program
  • Chattanooga, TN
National Provider Identifier
1306423322
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
979 E 3Rd St Ste B-401
Chattanooga, TN 37403-2136
Phone
(423) 778-7695
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 69458 TN
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

979 E 3Rd St Ste B-401
Chattanooga, TN 37403-2136

Mailing address

979 E 3Rd St Ste B-401
Chattanooga, TN 37403-2136
Phone (423) 778-7695

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
I20240117004593 TN Practitioner - General Practice 5193127199 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69458TNMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Dec 12, 2023 Accepting new patients

Locations

300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1306423322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST STE B-401",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032136",
            "telephone_number": "423-778-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST STE B-401",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032136",
            "telephone_number": "423-778-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCHILD",
        "first_name": "LEVIN",
        "middle_name": "DIRK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "69458",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.