Individual provider Active NPI

Mitchell L Mutter, MD

  • Cardiovascular Disease Physician
  • Chattanooga, TN
National Provider Identifier
1326047622
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
07785 Issued in TN
Practice address
979 E 3Rd St
Suite C-0925
Chattanooga, TN 37403-2136
Phone
(423) 697-2000
Fax
(423) 697-2118
NPI assigned
Jul 19, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 07785 TN Primary

Addresses

Primary practice location

979 E 3Rd St
Suite C-0925
Chattanooga, TN 37403-2136

Mailing address

2501 Citico Ave
Chattanooga, TN 37404-1127
Phone (423) 697-2000

Other identifiers 1

IdentifierTypeStateIssuer
3190102MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07785TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Care System, Inc. Cardiovascular Disease Current Accepting new patients
Cardiovascular Group, PC Cardiovascular Disease CurrentSince Oct 1, 1984 Accepting new patients
Memorial Health Care System Inc. Past Accepting new patients
Hutcheson Primary Care, LLC Past Accepting new patients

Locations

2501 Citico Ave
Chattanooga, TN 37404
Phone (423) 697-2318

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

979 E 3rd St
Ste C925
Chattanooga, TN 37403
Phone (423) 778-5910

400 Berywood Trl NW
Ste A
Cleveland, TN 37312
Phone (423) 697-3560

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, 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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326047622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CITICO AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041127",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST",
            "address_2": "SUITE C-0925",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032136",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTER",
        "first_name": "MITCHELL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "07785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3190102",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.