NPIMap

Organization Active NPI

Diagnostic Cardiology Group

  • Cardiovascular Disease Physician
  • Chattanooga, TN
National Provider Identifier
1437148152
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
DIAGNOSTIC CARDIOLOGY GROUP
Practice address
2341 McCallie Ave
Plaza 3, Ste. 200
Chattanooga, TN 37404-3239
Phone
(423) 629-4106
Fax
(423) 629-4116
NPI assigned
Oct 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Authorized official

Name
Theodore Richards, MDNPI 1891784518
Title
Ceo
Phone
(423) 629-4106

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X Primary
Clinical Cardiac Electrophysiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0001X

Addresses

Primary practice location

2341 McCallie Ave
Plaza 3, Ste. 200
Chattanooga, TN 37404-3239

Mailing address

2341 McCallie Ave
Plaza 3, Ste. 200
Chattanooga, TN 37404-3239
Phone (423) 629-4106

Other identifiers 1

IdentifierTypeStateIssuer
DC3036OtherTNRR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040907001032 TN Part B Supplier - Clinic/Group Practice 1052387495 Receives reassigned benefits from 11 practitioners
Practice locations: Chattanooga, TN
O20041011000108 GA Part B Supplier - Clinic/Group Practice 1052387495 Receives reassigned benefits from 8 practitioners
Practice locations: Fort Oglethorpe, GA; Ringgold, GA

National Provider Directory

National Provider Directory

Locations

112 Hedekin Cir
Ft Oglethorpe, GA 30742
Phone (706) 858-0580

102 Gross Crescent Cir
Ste 205
Ft Oglethorpe, GA 30742
Phone (706) 858-1195

221 Hedekin Cir
Ft Oglethorpe, GA 30742
Phone (706) 858-3988

2333 McCallie Ave
Ste 308
Chattanooga, TN 37404

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320019200000",
    "number": "1437148152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 MCCALLIE AVE",
            "address_2": "PLAZA 3, STE. 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043239",
            "telephone_number": "423-629-4106",
            "fax_number": "423-629-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 MCCALLIE AVE",
            "address_2": "PLAZA 3, STE. 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043239",
            "telephone_number": "423-629-4106",
            "fax_number": "423-629-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC CARDIOLOGY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2011-10-31",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-629-4106",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "DC3036",
            "state": "TN"
        }
    ],
    "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 Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.