Chickamauga Pediatric Emergency Physicians

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

CHICKAMAUGA PEDIATRIC EMERGENCY PHYSICIANS

Practice address

910 Blackford St
Chattanooga, TN 37403-1405

Phone

(423) 778-6101

NPI assigned

Jul 5, 2007

Organization subpart

No

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

Authorized official

Name

Jennifer Provasnik

Title

Supervisor of Provider Enrollment

Phone

(800) 355-0808

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518165018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13159",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013159",
            "telephone_number": "800-355-0808",
            "fax_number": "215-834-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BLACKFORD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031405",
            "telephone_number": "423-778-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICKAMAUGA PEDIATRIC EMERGENCY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PROVASNIK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SUPERVISOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "800-355-0808"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Denise Chesnutt, MN, APN
• Vincent Wyatt Chessor
• Cindy Elizabeth Chestaro, M.D.
• CHG Solutions LLC
• CHI National Home Care, LLC
• Lawrence T. Chien, MD
• Children'S Dentistry of Chattanooga, PLLC
• Children'S Home Chambliss Shelter
• Children'S University
• Childress & Meyer, PLLC

• Emergency Medicine Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.