Individual provider Active NPI

Sabra L Condra, FNP-C

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1316506967
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0000025776 Issued in TN
Practice address
975 E 3Rd St
Chattanooga, TN 37403-2163
Phone
(423) 602-8400
Fax
(423) 602-8401
NPI assigned
Jun 7, 2019
Last updated
Jun 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0000025776 TN Primary

Addresses

Primary practice location

975 E 3Rd St
Chattanooga, TN 37403-2163

Mailing address

PO Box 2930
Indianapolis, IN 46206-2930
Phone (866) 282-7905

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
I20190726002789 TN Practitioner - Nurse Practitioner 0244566347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Centers of East Tennessee, P.C.Group PAC ID 1951485150, 9 clinicians

Practice addresses (Care Compare)

4021 Keith St NW
Cleveland, TN 37312-4341
Phone (423) 476-2464

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000025776TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Centers of East Tennessee, P.C. CurrentSince May 1, 2021 Accepting new patients
Mahmood a Siddiqui MD PC Past Accepting new patients

Locations

4021 Keith St NW
Cleveland, TN 37312
Phone (423) 476-2464

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1316506967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2930",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062930",
            "telephone_number": "866-282-7905",
            "fax_number": "855-630-1300"
        },
        {
            "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": "374032163",
            "telephone_number": "423-602-8400",
            "fax_number": "423-602-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDRA",
        "first_name": "SABRA",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "0000025776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.