Organization Active NPI

David W Adcock MD PLLC

  • Plastic Surgery Physician
  • Chattanooga, TN
National Provider Identifier
1396983763
Registry record updated May 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD0000020999 Issued in TN
Legal business name
DAVID W ADCOCK MD PLLC
Practice address
251 N Lyerly St
Suite 200
Chattanooga, TN 37404-2728
Phone
(423) 648-5525
Fax
(423) 648-5240
NPI assigned
Jan 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2009

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

Authorized official

Name
David William Adcock, M.D.
Title
Owner
Phone
(423) 648-5525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X MD0000020999 TN Primary

Addresses

Primary practice location

251 N Lyerly St
Suite 200
Chattanooga, TN 37404-2728

Mailing address

251 N Lyerly St
Suite 200
Chattanooga, TN 37404-2728
Phone (423) 648-5525

Other identifiers 2

IdentifierTypeStateIssuer
4059237OtherTNBLUE CROSS BLUE SHIELD OF TENNESSEE
305312874AMedicaidGA

Other names 1

  • Aesthetic Plastic & Reconstructive Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

7305 Jarnigan Rd
Ste 100
Chattanooga, TN 37421
Phone (423) 485-9200

251 N Lyerly St
Ste 200
Chattanooga, TN 37404
Phone (423) 648-5525

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242345600000",
    "number": "1396983763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 N LYERLY ST",
            "address_2": "SUITE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374042728",
            "telephone_number": "423-648-5525",
            "fax_number": "423-648-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 N LYERLY ST",
            "address_2": "SUITE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374042728",
            "telephone_number": "423-648-5525",
            "fax_number": "423-648-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID W ADCOCK MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-05-15",
        "status": "A",
        "authorized_official_last_name": "ADCOCK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-648-5525",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "TN",
            "license": "MD0000020999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TENNESSEE",
            "identifier": "4059237",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305312874A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aesthetic Plastic & Reconstructive Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.