Individual provider Active NPI

Carol Beth Isenberg, FNP

  • Family Nurse Practitioner
  • Dalton, GA
National Provider Identifier
1508121575
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN000016778 Issued in TN
Practice address
1107 Memorial Dr
Suite 201
Dalton, GA 30720-8668
Phone
(706) 277-7311
Fax
(706) 272-3512
NPI assigned
Jul 5, 2012
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN000016778 TN Primary

Addresses

Primary practice location

1107 Memorial Dr
Suite 201
Dalton, GA 30720-8668

Mailing address

136 Battlefield Crossing CT
Ringgold, GA 30736-5176
Phone (706) 277-7311

Other names 1

  • Carol Beth Marrs Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jychung@directaddress.net Skin Cancer & Cosmetic Dermatology Center, PC
Direct Messaging Address jychung@directaddress.net Skin Cancer & Cosmetic Dermatology Center, PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131227000049 GA Practitioner - Nurse Practitioner 2961639737
I20131227000059 TN Practitioner - Nurse Practitioner 2961639737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uderm, PLLCGroup PAC ID 8325458532, 9 clinicians

Practice addresses (Care Compare)

2835 Northpoint Blvd
Suite 111
Hixson, TN 37343-4862
Phone (423) 870-3376

5243 Little Debbie Pkwy
Suite 111
Ooltewah, TN 37363-4515
Phone (423) 206-2777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.97 of 100Reported as group
Quality
83.94
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Uderm, PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2051 Hamill Rd
Ste 301
Hixson, TN 37343
Phone (423) 870-3376

2835 Northpoint Blvd
Ste 101
Hixson, TN 37343

5243 Little Debbie Pkwy
Ste 111
Ooltewah, TN 37363
Phone (423) 206-2777

Interoperability endpoints

  • Direct secure messaging: carol.marrs@sccdc.gadirect.net
  • Direct secure messaging: cisenberg@uderm.emadirect.md

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.

Hospital & facility affiliations 2

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": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1508121575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 BATTLEFIELD CROSSING CT",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307365176",
            "telephone_number": "706-277-7311",
            "fax_number": "706-529-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR",
            "address_2": "SUITE 201",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208668",
            "telephone_number": "706-277-7311",
            "fax_number": "706-272-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISENBERG",
        "first_name": "CAROL",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN000016778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer & Cosmetic Dermatology Center, PC",
            "address_1": "1107 Memorial Dr",
            "address_2": "Suite 201",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307208668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer & Cosmetic Dermatology Center, PC",
            "address_1": "2253 Chambliss Ave NW",
            "address_2": "Suite 202",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373113861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "MARRS",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.