Kathy Cartwright Philyaw, MD

Individual provider Active NPI Pediatrics Physician · South Pittsburg, TN

NPI 1366547879 · NPPES record last updated Jul 21, 2021

Key facts

NPI
1366547879
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
30360 (TN)
Practice address
325 South Cedar Avenue
Suite 1
South Pittsburg, TN 37380-1305
Phone
(423) 228-4159
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Specialists of Marion County PLLC Pediatrics Past
since Jul 25, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 30360 TN Yes

Addresses

Primary practice location

325 South Cedar Avenue
Suite 1
South Pittsburg, TN 37380-1305

Mailing address

325 South Cedar Avenue
Suite 1
South Pittsburg, TN 37380-1305
Phone (423) 228-4159

Other identifiers

IdentifierTypeStateIssuer
4076374OtherTNBCBS PROVIDER NUMBER
1504526MedicaidTN
TN0102OtherTNAMERICHOICE PROVIDER NUMBER
TN0102OtherTNUNITED HEALTHCARE OF RIVERVALLEY PROVIDER NUMBER

Other providers in South Pittsburg, TN

All providers in South Pittsburg, TN · Pediatrics Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.