Individual provider Active NPI

Ahmed A Ibrahim, M.D.

  • Psychiatry Physician
  • Chattanooga, TN
National Provider Identifier
1407188626
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
44834 Issued in KY
Practice address
7351 Courage Way
Chattanooga, TN 37421-1555
Phone
(423) 499-2300
NPI assigned
Feb 12, 2010
Last updated
Apr 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 44834 KY Primary

Addresses

Primary practice location

7351 Courage Way
Chattanooga, TN 37421-1555

Mailing address

7351 Courage Way
Chattanooga, TN 37421-1555
Phone (423) 499-2300

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
I20131004000233 TN Practitioner - Psychiatry 4082848148 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chattanooga Diagnostic Associates LLCGroup PAC ID 9739272519, 27 clinicians
Scenic City Neurotherapy and Ketamine Center LLCGroup PAC ID 7416386941, 2 clinicians

Practice addresses (Care Compare)

2205 McCallie Ave
Chattanooga, TN 37404-3230
Phone (423) 698-2435

7405 Shallowford Rd
Suite 240
Chattanooga, TN 37421-2662
Phone (423) 228-0579

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44834KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scenic City Neurotherapy and Ketamine Center LLC Psychiatry CurrentSince Aug 1, 2020 Accepting new patients
Chattanooga Diagnostic Associates LLC CurrentSince Oct 14, 2018 Accepting new patients
Parkridge Medical Center, Inc. Past Accepting new patients
Parkridge Medical Center, Inc. Past Accepting new patients
Parkridge Medical Center, Inc. Past Accepting new patients

Locations

100 Moccasin Bend Rd
Chattanooga, TN 37405
Phone (423) 785-3321

2205 McCallie Ave
Chattanooga, TN 37404
Phone (423) 508-6733

7351 Courage Way
Chattanooga, TN 37421
Phone (423) 499-2300

7405 Shallowford Rd
Ste 240
Chattanooga, TN 37421
Phone (423) 228-0579

7405 Shallowford Rd
Ste 360
Chattanooga, TN 37421
Phone (423) 228-0579

1000 Highway 28
Jasper, TN 37347
Phone (423) 837-9500

Interoperability endpoints

  • Direct secure messaging: ahmed.ibrahim@hca1.eclinicaldirectplus.com

Organizations & group practices 7

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 1

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": "1265932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1407188626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7351 COURAGE WAY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211555",
            "telephone_number": "423-499-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7351 COURAGE WAY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211555",
            "telephone_number": "423-499-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "AHMED",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-12",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "44834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.