Individual provider Active NPI

David Newton Collins, MD

  • Gastroenterology Physician
  • Chattanooga, TN
National Provider Identifier
1417949900
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
11038 Issued in TN
Practice address
725 Glenwood Dr
Ste 690 E
Chattanooga, TN 37404-1163
Phone
(423) 622-0694
Fax
(423) 629-7643
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 11038 TN Primary

Addresses

Primary practice location

725 Glenwood Dr
Ste 690 E
Chattanooga, TN 37404-1163

Mailing address

725 Glenwood Dr
Ste 690 E
Chattanooga, TN 37404-1163
Phone (423) 622-0694

Other identifiers 1

IdentifierTypeStateIssuer
3001388MedicaidTN

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
I20050419001261 TN Practitioner - GastroenterologyPractitioner - Internal Medicine 5799765038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11038TNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1417949900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "STE 690 E",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-622-0694",
            "fax_number": "423-629-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "STE 690 E",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-622-0694",
            "fax_number": "423-629-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "DAVID",
        "middle_name": "NEWTON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "11038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001388",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.