Individual provider Active NPI

Kevin Gene Mounce, PA

  • Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1508809617
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0000053 Issued in TN
Practice address
1 Siskin PLZ
Chattanooga, TN 37403-1306
Phone
(423) 634-4226
Fax
(423) 634-4222
NPI assigned
Jun 14, 2006
Last updated
Oct 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0000053 TN Primary

Addresses

Primary practice location

1 Siskin PLZ
Chattanooga, TN 37403-1306

Mailing address

1 Siskin PLZ
Chattanooga, TN 37403-1306
Phone (423) 634-4226

Other identifiers 2

IdentifierTypeStateIssuer
3662060MedicaidTN
4131998OtherTNBCBSTN

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
I20040310000244 TN Practitioner - Physician Assistant 9436047461 Reassigns benefits to 1 organization

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0000053TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Chattanooga Rehabilitation Associates, PC Past Accepting new patients
Chattanooga Spine & Rehabilitation PLLC Past Accepting new patients

Locations

1635 Gunbarrel Rd
Ste 410
Chattanooga, TN 37421
Phone (423) 778-5437

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

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

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

4312 Holiday Inn Express Way NW
Ste 202
Cleveland, TN 37312
Phone (423) 778-8523

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

Organizations & group practices 4

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1508809617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SISKIN PLZ",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031306",
            "telephone_number": "423-634-4226",
            "fax_number": "423-634-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SISKIN PLZ",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031306",
            "telephone_number": "423-634-4226",
            "fax_number": "423-634-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNCE",
        "first_name": "KEVIN",
        "middle_name": "GENE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3662060",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN",
            "identifier": "4131998",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.