Individual provider Active NPI

William A Chandler Jr., PA-C

  • Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1528088192
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1106 Issued in TN
Practice address
4413 Oakwood Drive
Chattanooga, TN 37416-2367
Phone
(423) 553-1823
Fax
(423) 553-1829
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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 1106 TN Primary

Addresses

Primary practice location

4413 Oakwood Drive
Chattanooga, TN 37416-2367

Mailing address

4413 Oakwood Drive
Chattanooga, TN 37416-2367
Phone (423) 553-1823

Other identifiers 1

IdentifierTypeStateIssuer
1509719MedicaidTN

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
I20040301000484 TN Practitioner - Physician Assistant 2567359078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palliative Care Services, PLLC 19 clinicians

Practice addresses (Care Compare)

2030 Hamilton Place Blvd
Suite 220
Chattanooga, TN 37421-6040
Phone (423) 892-4289

Hospital & facility affiliations

  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee River Physicians, PLLC CurrentSince Jun 20, 2017 Accepting new patients
Tennessee Em-I Medical Services, PC Past Accepting new patients
Hargrave Emergency Physicians LLC Physician Assistant Past Accepting new patients
Emergency Physicians PC Past Accepting new patients

Locations

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

71 Wheelertown Ave
Pikeville, TN 37367
Phone (423) 447-2112

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1528088192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 OAKWOOD DRIVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374162367",
            "telephone_number": "423-553-1823",
            "fax_number": "423-553-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 OAKWOOD DRIVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374162367",
            "telephone_number": "423-553-1823",
            "fax_number": "423-553-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509719",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.