Individual provider Active NPI

Gracelyn Cheruba Bose, MD, MBA

  • Internal Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1326780537
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
74108 Issued in TN
Practice address
960 E 3Rd St Ste 104
Chattanooga, TN 37403-2138
Phone
(423) 778-7442
NPI assigned
Apr 8, 2022
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 74108 TN Primary

Addresses

Primary practice location

960 E 3Rd St Ste 104
Chattanooga, TN 37403-2138

Mailing address

13441 Boxelder CT
Carmel, IN 46074-5500
Phone (812) 217-9119

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
I20250723001547 TN Practitioner - Internal Medicine 8820504129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

979 E 3Rd St
Chattanooga, TN 37403-2136
Phone (423) 776-4408

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
74108TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2025 Accepting new patients

Locations

979 E 3rd St
Ste B601
Chattanooga, TN 37403
Phone (423) 778-8179

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

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.

Hospital & facility affiliations 1

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": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1326780537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13441 BOXELDER CT",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460745500",
            "telephone_number": "812-217-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 E 3RD ST STE 104",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032138",
            "telephone_number": "423-778-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSE",
        "first_name": "GRACELYN",
        "middle_name": "CHERUBA",
        "credential": "MD, MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-08",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "74108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.