NPIMap

Individual provider Active NPI

Kent A Grotefendt, MD

  • Family Medicine Physician
  • Ooltewah, TN
National Provider Identifier
1467439026
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27518 Issued in TN
Practice address
6401 Mountain View Road
Suite 109
Ooltewah, TN 37363-6685
Phone
(423) 495-5951
Fax
(423) 495-5999
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27518 TN Primary

Addresses

Primary practice location

6401 Mountain View Road
Suite 109
Ooltewah, TN 37363-6685

Mailing address

6401 Mountain View Road
Suite 109
Ooltewah, TN 37363-6685
Phone (423) 495-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921000653 TN Practitioner - Family Practice 9133244684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5600 Brainerd Rd
Suite 500
Chattanooga, TN 37411-5371
Phone (423) 414-3586

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions22
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27518TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation Inc Family Medicine CurrentSince Nov 1, 2002 Accepting new patients
Memorial Health Partners Foundation, Inc Family Medicine CurrentSince Nov 1, 2002 Accepting new patients
Memorial Health Partners Foundation Inc Family Medicine Current Accepting new patients

Locations

100 Gross Crescent Cir
Ft Oglethorpe, GA 30742
Phone (706) 858-2301

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

6401 Mountain View Rd
Ste 109
Ooltewah, TN 37363
Phone (423) 495-5951

Interoperability endpoints

  • Direct secure messaging: kentgrotefendt@tnmhpf.allscriptsdirect.net
  • Direct secure messaging: kgrotefendt133379@direct.stlukeshealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1467439026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 MOUNTAIN VIEW ROAD",
            "address_2": "SUITE 109",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636685",
            "telephone_number": "423-495-5951",
            "fax_number": "423-495-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 MOUNTAIN VIEW ROAD",
            "address_2": "SUITE 109",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636685",
            "telephone_number": "423-495-5951",
            "fax_number": "423-495-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTEFENDT",
        "first_name": "KENT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "27518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

Verify at the official NPI Registry.