John Marvin Lytle Jr.
Individual provider Active NPI Adult Health Nurse Practitioner · Cleveland, TN
NPI 1356092571 · NPPES record last updated Jan 11, 2022
Key facts
- NPI
- 1356092571
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 30618 (TN)
- Practice address
- 2020 Westland Dr SW
Cleveland, TN 37311-8163 - Phone
- (423) 478-1970
- NPI assigned
- Jan 11, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 16
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Erlanger Health
Practice addresses (Care Compare)
7380 Volkswagen Dr
Suite 110
Chattanooga, TN 37416-1761
Phone (423) 778-8950
Hospital & facility affiliations
- Erlanger Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
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 |
|---|---|---|---|---|
| I20220708001296 | TN | Practitioner - Nurse Practitioner | 1951781970 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30618 | TN | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocoee Regional Health Corporation | Current |
Accepting new patients | |
| Ocoee Regional Health Corporation | Current |
Accepting new patients | |
| Chattanooga Hamilton County Hospital Authority | Current |
Accepting new patients | |
| Ocoee Regional Health Corporation | Current | Accepting new patients | |
| Chattanooga Hamilton County Hospital Authority | Current |
Accepting new patients | |
| Erlanger Health | Current |
Accepting new patients | |
| Erlanger Health | Current |
Accepting new patients |
Locations
1200 Dodson Ave
Chattanooga, TN 37406
Phone (423) 778-2800
975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499
3800 Tennessee Ave
Ste 124
Chattanooga, TN 37409
Phone (423) 778-2700
7380 Volkswagen Dr
Ste 110
Chattanooga, TN 37416
Phone (423) 778-8950
2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 30618 | TN | Yes |
Addresses
Primary practice location
2020 Westland Dr SW
Cleveland, TN 37311-8163
Mailing address
5346 Collegeview Dr
Ooltewah, TN 37363-8734
Phone (772) 349-1084
Other providers in Cleveland, TN
- Caroline Balmer Lundy
- Lux Med Transportation
- Kristen Lyle
- Megan Lynch
- Nicholas Lynn
- Catherine Mabee
- Danielle Leayn Maddox
- Chloe Hillis Madewell
- Magnolia Dental Center of Cleveland, LLC
- Joseph Kyle Mahaffey
All providers in Cleveland, TN · Adult Health Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2022. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.