Individual provider Active NPI

Susan B. Gain, APRN-BC, PNP

  • Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1477552347
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13768 Issued in TN
Practice address
910 Blackford Street
Chattanooga, TN 37403-1405
Phone
(423) 778-6476
Fax
(423) 778-4232
NPI assigned
Jul 21, 2005
Last updated
Oct 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2953602 FL
Nurse Practitioner 363L00000X 13768 TN Primary

Addresses

Primary practice location

910 Blackford Street
Chattanooga, TN 37403-1405

Mailing address

PO Box 11503
Chattanooga, TN 37401-2503
Phone (423) 778-3274

Other identifiers 2

IdentifierTypeStateIssuer
451755976AMedicaidGA
306729700MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000748 TN Practitioner - Nurse Practitioner 7214124999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP2953602FLMDNurse Practitioner
13768TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Oct 1, 2010 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Oct 1, 2010 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Erlanger Health Past Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

910 Blackford St
Chattanooga, TN 37403
Phone (423) 778-4044

632 Morrison Springs Rd
Ste 202
Chattanooga, TN 37415
Phone (423) 778-3329

900 E 3rd St
Chattanooga, TN 37403
Phone (423) 778-5437

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

9448 Dayton Pike
Soddy Daisy, TN 37379
Phone (423) 266-7111

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1477552347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11503",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374012503",
            "telephone_number": "423-778-3274",
            "fax_number": "423-778-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BLACKFORD STREET",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031405",
            "telephone_number": "423-778-6476",
            "fax_number": "423-778-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAIN",
        "first_name": "SUSAN",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC, PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2953602",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "13768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "451755976A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306729700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.