NPIMap

Organization Active NPI

Beacon Health Alliance PC

  • Internal Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1447205182
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BEACON HEALTH ALLIANCE PC
Practice address
725 Glenwood Dr
Suite 480E
Chattanooga, TN 37404-1163
Phone
(423) 756-5779
Fax
(423) 242-4552
NPI assigned
May 23, 2006
Last updated
Nov 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Authorized official

Name
Dr. Collin G CherryNPI 1659375491
Title
President
Phone
(423) 756-5779

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

725 Glenwood Dr
Suite 480E
Chattanooga, TN 37404-1163

Mailing address

725 Glenwood Dr
Suite 480E
Chattanooga, TN 37404-1163
Phone (423) 756-5779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308000065 TN Part B Supplier - Clinic/Group Practice 7911895412 Receives reassigned benefits from 17 practitioners
Practice locations: Signal Mountain, TN; Chattanooga, TN; Hixson, TN

National Provider Directory

National Provider Directory
Tax ID family
Beacon Health Alliance PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1751 Gunbarrel Rd
Ste 100
Chattanooga, TN 37421
Phone (423) 778-9500

1751 Gunbarrel Rd
Ste 110
Chattanooga, TN 37421
Phone (423) 778-9500

2501 Citico Ave
Ste 300
Chattanooga, TN 37404
Phone (423) 756-5779

3370 Jenkins Rd
Chattanooga, TN 37421
Phone (423) 648-8005

725 Glenwood Dr
Ste E480
Chattanooga, TN 37404
Phone (423) 629-1491

7550 Goodwin Rd
Chattanooga, TN 37421
Phone (423) 894-3252

979 E 3rd St
Ste 601
Chattanooga, TN 37403
Phone (423) 756-8871

2051 Hamill Rd
Ste 300
Hixson, TN 37343
Phone (423) 778-9500

4519 Hixson Pike
Hixson, TN 37343
Phone (423) 877-4591

1303 Taft Hwy
Signal Mtn, TN 37377
Phone (423) 886-7529

Practitioners & affiliated clinicians

Practitioners 62

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1447205182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "SUITE 480E",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-756-5779",
            "fax_number": "423-242-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "SUITE 480E",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-756-5779",
            "fax_number": "423-242-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON HEALTH ALLIANCE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "CHERRY",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-756-5779",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Nov 8, 2012; 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.