Organization Active NPI

Galen Medical Group, PC

  • Internal Medicine Physician
  • Hixson, TN
National Provider Identifier
1346250057
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GALEN MEDICAL GROUP, PC
Practice address
4976 Alpha LN
Hixson, TN 37343-5470
Phone
(423) 497-5355
Fax
(423) 308-0281
NPI assigned
Aug 8, 2006
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Dr. Benjamin Wiley, MDNPI 1780649780
Title
Medical Director
Phone
(423) 308-0280

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 15

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Hepatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0008X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Dermatopathology (Pathology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZD0900X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatric Allergy/Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0201X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X

Addresses

Primary practice location

4976 Alpha LN
Hixson, TN 37343-5470

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 497-5355

Other identifiers 2

IdentifierTypeStateIssuer
3703397MedicaidTN
300040275RMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031204001027 TN Part B Supplier - Clinic/Group Practice 2668377391 Receives reassigned benefits from 162 practitioners
Practice locations: Chattanooga, TN; Cleveland, TN; Hixson, TN; Ooltewah, TN
O20060823000294 GA Part B Supplier - Clinic/Group Practice 2668377391 Receives reassigned benefits from 19 practitioners
Practice locations: Fort Oglethorpe, GA; Ringgold, GA; Dalton, GA
O20181211001176 TN MDPP Supplier - in-Person MDPP Supplier 2668377391 Practice locations: Chattanooga, TN; Hixson, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0859137Galen Medical Group Laboratory PC4976 Alpha Lane, Hixson, TN 37343ComplianceApr 20, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations (25 of 29)

1107 Memorial Dr
Ste G2
Dalton, GA 30720
Phone (706) 529-3245

4700 Battlefield Pkwy
Ste 210
Ringgold, GA 30736
Phone (423) 698-8101

1651 Gunbarrel Rd
Chattanooga, TN 37421

1651 Gunbarrel Rd
#S301
Chattanooga, TN 37421
Phone (423) 899-2580

1651 Gunbarrel Rd
Ste 103
Chattanooga, TN 37421
Phone (423) 308-0480

1651 Gunbarrel Rd
Ste 201
Chattanooga, TN 37421
Phone (423) 899-9133

1651 Gunbarrel Rd
Ste 302
Chattanooga, TN 37421
Phone (423) 899-2904

1700 Broad St
Ste 140
Chattanooga, TN 37408
Phone (423) 493-5240

1720 Gunbarrel Rd
#S400
Chattanooga, TN 37421

1720 Gunbarrel Rd
Ste 410
Chattanooga, TN 37421
Phone (423) 497-5359

2200 E 3rd St
Ste 200
Chattanooga, TN 37404
Phone (423) 643-2500

3354 Charger Dr
Chattanooga, TN 37409
Phone (423) 265-6411

4650 Buccaneer Trl
Chattanooga, TN 37411
Phone (423) 622-6177

5600 Brainerd Rd
Ste 100
Chattanooga, TN 37411
Phone (423) 308-0280

7236 Bonny Oaks Dr
Chattanooga, TN 37421
Phone (423) 892-2319

7425 Ziegler Rd
Ste 131
Chattanooga, TN 37421
Phone (423) 308-0280

960 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-7172

961 Spring Creek Rd
#C30463
Chattanooga, TN 37412
Phone (423) 892-2221

979 E 3rd St
Ste C520
Chattanooga, TN 37403
Phone (423) 778-4465

1011 Peerless Xing NW
Cleveland, TN 37312

1060 Peerless Xing NW
Ste 100
Cleveland, TN 37312
Phone (423) 339-5656

2253 Chambliss Ave NW
#S401
Cleveland, TN 37311

1008 Executive Dr
Hixson, TN 37343

1008 Executive Dr
Ste 104
Hixson, TN 37343
Phone (423) 497-5363

1039 Executive Dr
Hixson, TN 37343

Practitioners & affiliated clinicians

Practitioners 270

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 270

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1346250057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALEN MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "423-308-0280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hepatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3703397",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300040275R",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.