Robert Kevin Chin, PA-C
Individual provider Active NPI Physician Assistant · Athens, TN
NPI 1336367671 · NPPES record last updated Nov 18, 2016
Key facts
- NPI
- 1336367671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA753 (TN)
- Practice address
- 711 Cook Dr Ste 100
Athens, TN 37303-3499 - Phone
- (423) 744-7585
- Fax
- (423) 746-4993
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040210001138 | TN | Practitioner - Physician Assistant | 7719870401 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA753 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athens Physicians Practice LLC | Current |
Accepting new patients | |
| Cleveland Tennessee Hospital Company LLC | Past | Accepting new patients | |
| Southern Medical Clinics, LLC | Physician Assistant | Past | Accepting new patients |
| Cleveland Medical Clinic Inc | Physician Assistant | Past | Accepting new patients |
| Athens Physicians Practice LLC | Past | Accepting new patients |
Locations
711 Cook Dr
Ste 100
Athens, TN 37303
Phone (423) 744-7585
719 Cook Dr
Ste 104
Athens, TN 37303
Phone (423) 745-9770
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
872 Highway 411 N
Unit G
Etowah, TN 37331
Phone (423) 744-7585
Interoperability endpoints
- robert.chin@164749367312388.direct.elationemr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA753 | TN | Yes |
Addresses
Primary practice location
711 Cook Dr Ste 100
Athens, TN 37303-3499
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-5098
Other providers in Athens, TN
- Charles B Cox MDPC
- Chattanooga Orthopaedic Group, PC
- Cherokee Medical Group PC
- Barbara Ruth Childress
- David Ryan Childress
- Ami Christensen
- Lacy Nicole Chupp
- Debi A Church
- Kayla Gabrielle Clare
- James A Clark
All providers in Athens, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.