Organization Active NPI

Chattanooga Foot Specialists, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Chattanooga, TN
National Provider Identifier
1487747457
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
590 Issued in TN
Legal business name
CHATTANOOGA FOOT SPECIALISTS, PLLC
Practice address
2707 Citico Ave
Chattanooga, TN 37406-3402
Phone
(843) 628-0023
Fax
(423) 698-8269
NPI assigned
Oct 2, 2006
Last updated
Apr 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Authorized official

Name
Lisa Wamack, DPMNPI 1609891530
Title
Practice Owner
Phone
(423) 698-4899

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 590 TN Primary

Addresses

Primary practice location

2707 Citico Ave
Chattanooga, TN 37406-3402

Mailing address

2707 Citico Ave
Chattanooga, TN 37406-3402
Phone (423) 698-4899

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610000915 TN Part B Supplier - Clinic/Group Practice 7113900184 Receives reassigned benefits from 1 practitioner
Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory

Locations

721 Glenwood Dr
Ste W562
Chattanooga, TN 37404
Phone (423) 624-5598

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1487747457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 CITICO AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374063402",
            "telephone_number": "423-698-4899",
            "fax_number": "423-698-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 CITICO AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374063402",
            "telephone_number": "843-628-0023",
            "fax_number": "423-698-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTANOOGA FOOT SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "WAMACK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "423-698-4899",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TN",
            "license": "590",
            "primary": true
        }
    ],
    "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 Apr 7, 2023; 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.