Individual provider Active NPI

David Gardenhire

  • Personal Care Attendant
  • Chattanooga, TN
National Provider Identifier
1487331203
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
L000000032292 Issued in TN
Practice address
7104 Bonny Oaks Dr
Chattanooga, TN 37421-1003
Phone
(423) 893-9993
NPI assigned
Jul 3, 2023
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X L000000032292 TN Primary

Addresses

Primary practice location

7104 Bonny Oaks Dr
Chattanooga, TN 37421-1003

Mailing address

7104 Bonny Oaks Dr
Chattanooga, TN 37421-1003
Phone (423) 893-9993

Other identifiers 1

IdentifierTypeStateIssuer
1518109982OtherTNNON-MEDICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L000000032292TNMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
LV at HM Inc Or Home Instead CurrentSince Jul 31, 2023 Accepting new patients

Locations

7104 Bonny Oaks Dr
Chattanooga, TN 37421
Phone (423) 893-9993

Organizations & group practices 1

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": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1487331203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7104 BONNY OAKS DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211003",
            "telephone_number": "423-893-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7104 BONNY OAKS DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211003",
            "telephone_number": "423-893-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDENHIRE",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "TN",
            "license": "L000000032292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON-MEDICAL",
            "identifier": "1518109982",
            "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 Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.