Individual provider Active NPI

Joshua Thomas Derryberry, MD

  • Family Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1396980009
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58172 Issued in TN
Practice address
1651 Gunbarrel Rd Ste 302
Chattanooga, TN 37421-3291
Phone
(423) 899-2904
Fax
(423) 892-5058
NPI assigned
Dec 9, 2008
Last updated
Apr 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58172 TN Primary

Addresses

Primary practice location

1651 Gunbarrel Rd Ste 302
Chattanooga, TN 37421-3291

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 308-0280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181204001302 TN Practitioner - Family Practice 0941596472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Galen Medical Group, PCGroup PAC ID 2668377391, 122 clinicians

Practice addresses (Care Compare)

1651 Gunbarrel Rd
Suite 302
Chattanooga, TN 37421-3291
Phone (423) 899-2904

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Medical Group, PC Family Medicine CurrentSince Oct 1, 2018 Accepting new patients
Aadi, LLC PastSince May 6, 2020 Accepting new patients

Locations

1651 Gunbarrel Rd
Ste 301
Chattanooga, TN 37421
Phone (423) 899-2580

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

7425 Ziegler Rd
Ste 101
Chattanooga, TN 37421
Phone (423) 702-9218

4976 Alpha Ln
Hixson, TN 37343
Phone (423) 308-0280

Organizations & group practices 2

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1396980009",
    "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": "423-308-0280",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 GUNBARREL RD STE 302",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213291",
            "telephone_number": "423-899-2904",
            "fax_number": "423-892-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRYBERRY",
        "first_name": "JOSHUA",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-09",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "58172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.