Individual provider Active NPI

Padmavathi Geddam, MD

  • Psychiatry Physician
  • Chattanooga, TN
National Provider Identifier
1316034390
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD38532 Issued in TN
Practice address
601 Cumberland St
Chattanooga, TN 37404-1922
Phone
(423) 266-6751
Fax
(423) 763-4650
NPI assigned
Oct 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD38532 TN Primary

Addresses

Primary practice location

601 Cumberland St
Chattanooga, TN 37404-1922

Mailing address

6049 Shallowford Road
Chattanooga, TN 37421-1688
Phone (423) 266-6751

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150428002170 GA Practitioner - PsychiatryPractitioner - Neurology 7416996350 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD38532TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers CSB CurrentSince Dec 20, 2014 Accepting new patients
Highland Rivers CSB CurrentSince Dec 20, 2014 Accepting new patients
Highland Rivers Community Service Board Current Accepting new patients
Mental Health Centers & Clinics of Tennessee Past Accepting new patients
Highland Rivers CSB Past Accepting new patients
American Medical Response of Tennessee, Inc. Past Accepting new patients
Highland Rivers CSB Past Accepting new patients
Helen Ross McNabb Center PastSince Apr 20, 2013 Accepting new patients

Locations

100 Wright Ct NE
Calhoun, GA 30701
Phone (706) 629-5200

191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600

650 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (770) 387-3538

1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507

900 Shugart Rd
Ste B
Dalton, GA 30720
Phone (706) 270-5027

1401 Applewood Dr
Ste 1
Dalton, GA 30720
Phone (706) 270-5003

1179 Progress Rd
Ellijay, GA 30540
Phone (706) 635-2739

323 Roland Rd
Jasper, GA 30143
Phone (706) 253-1112

Organizations & group practices 8

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1316034390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6049 SHALLOWFORD ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211688",
            "telephone_number": "423-266-6751",
            "fax_number": "423-763-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CUMBERLAND ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041922",
            "telephone_number": "423-266-6751",
            "fax_number": "423-763-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDDAM",
        "first_name": "PADMAVATHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-09",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD38532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.