Organization Active NPI

Liver and Gastroenterology Center

  • Gastroenterology Physician
  • Chattanooga, TN
National Provider Identifier
1386836070
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
LIVER AND GASTROENTEROLOGY CENTER
Practice address
725 Glenwood Dr
Memorial Medical BLDG East Suite 488E
Chattanooga, TN 37404-1163
Phone
(423) 697-0621
Fax
(423) 697-8716
NPI assigned
Aug 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Authorized official

Name
Jay M Philippose, MD
Title
Owner
Phone
(423) 697-0621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

725 Glenwood Dr
Memorial Medical BLDG East Suite 488E
Chattanooga, TN 37404-1163

Mailing address

725 Glenwood Dr
Memorial Medical BLDG East Suite 488E
Chattanooga, TN 37404-1163
Phone (423) 697-0621

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
44D1036466Liver & Gastroenterology Center725 Glenwood Dr Suite488 East, Chattanooga, TN 37404Certificate of waiverFeb 3, 2027

National Provider Directory

National Provider Directory

Locations

2341 McCallie Ave
Ste 302
Chattanooga, TN 37404
Phone (423) 629-9743

725 Glenwood Dr
Ste 488
Chattanooga, TN 37404
Phone (423) 697-0621

2339 McCallie Ave
Ste 302
Chattanooga, TN 37404
Phone (423) 697-0621

Practitioners & affiliated clinicians

Practitioners 1

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": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1386836070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "MEMORIAL MEDICAL BLDG EAST SUITE 488E",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-697-0621",
            "fax_number": "423-697-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "MEMORIAL MEDICAL BLDG EAST SUITE 488E",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-697-0621",
            "fax_number": "423-697-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVER AND GASTROENTEROLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "PHILIPPOSE",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-697-0621",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.