East TN Neurology LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

EAST TN NEUROLOGY LLC

Practice address

1720 Gunbarrel Rd Ste 306
Chattanooga, TN 37421-3192

Phone

(423) 790-1529

NPI assigned

Jul 11, 2012

Organization subpart

No

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

Authorized official

Name

Subroto KunduNPI 1063426302

Title

Owner

Phone

(423) 790-1529

Specialties & licenses 1

Addresses

Other names 1

• East TN Neurology of Chattanooga Other name

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Subroto Kundu, M.D.

  • Neurology Physician
  • Cleveland, TN
  • NPI 1063426302
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1538424072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 KEITH ST NW STE 211",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124375",
            "telephone_number": "423-476-5406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 GUNBARREL RD STE 306",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213192",
            "telephone_number": "423-790-1529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3555 Keith St NW Ste 211",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373124375",
            "country_code": "US",
            "telephone_number": "423-790-1529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST TN NEUROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "KUNDU",
        "authorized_official_first_name": "SUBROTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-790-1529"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East TN Neurology of Chattanooga",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Neurology Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Neurology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.