Organization Active NPI

Vincent a. Viscomi, MD PC

  • Pulmonary Disease Physician
  • Chattanooga, TN
National Provider Identifier
1336175736
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
VINCENT A. VISCOMI, MD PC
Practice address
725 Glenwood Drive
Suite E-680
Chattanooga, TN 37404-1176
Phone
(423) 495-7378
Fax
(423) 495-4425
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Authorized official

Name
Vincent A Viscomi, MDNPI 1982689493
Title
MD/Owner
Phone
(423) 495-7378

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

725 Glenwood Drive
Suite E-680
Chattanooga, TN 37404-1176

Mailing address

PO Box 24325
Chattanooga, TN 37422-4325
Phone (423) 495-7378

Other identifiers 2

IdentifierTypeStateIssuer
3049230MedicaidTN
DG8484OtherTNRR MEDICARE TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060120000393 GA Part B Supplier - Clinic/Group Practice 8426072190 Receives reassigned benefits from 1 practitioner
Practice locations: Chattanooga, TN; Hixson, TN
O20071023000403 TN Part B Supplier - Clinic/Group Practice 8426072190 Receives reassigned benefits from 1 practitioner
Practice locations: Chattanooga, TN; Hixson, TN

National Provider Directory

National Provider Directory

Locations

2205 McCallie Ave
Ste 501
Chattanooga, TN 37404
Phone (423) 495-7378

2525 Desales Ave
Ste W461
Chattanooga, TN 37404

725 Glenwood Dr
Ste 680
Chattanooga, TN 37404

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1336175736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24325",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374224325",
            "telephone_number": "423-495-7378",
            "fax_number": "423-495-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DRIVE",
            "address_2": "SUITE E-680",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041176",
            "telephone_number": "423-495-7378",
            "fax_number": "423-495-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT A. VISCOMI, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "VISCOMI",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "423-495-7378",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3049230",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE TN",
            "identifier": "DG8484",
            "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 Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.