NPIMap

Individual provider Active NPI

Richard W Brackett, MD

  • Rheumatology Physician
  • Chattanooga, TN
National Provider Identifier
1568564672
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
16562 Issued in TN
Practice address
6145 Shallowford Rd
Ste 102
Chattanooga, TN 37421
Phone
(423) 893-6890
Fax
(423) 648-1115
NPI assigned
Sep 1, 2006
Last updated
Jan 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 16562 TN Primary

Addresses

Primary practice location

6145 Shallowford Rd
Ste 102
Chattanooga, TN 37421

Mailing address

6145 Shallowford Rd
Ste 102
Chattanooga, TN 37421
Phone (423) 893-6890

Other identifiers 2

IdentifierTypeStateIssuer
4110715OtherTNBLUE CROSS BLUE SHIELD
3731246MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050923000778 TN Practitioner - Rheumatology 2365476876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Tennessee, HSC, College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scenic City Rheumatology, PLLCGroup PAC ID 4183658693, 5 clinicians

Practice addresses (Care Compare)

6145 Shallowford Rd
Suite 102
Chattanooga, TN 37421-7808
Phone (423) 893-6890

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.75 of 100Reported as group
Quality
97.51
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16562TNMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scenic City Rheumatology PLLC CurrentSince Oct 1, 2005 Accepting new patients
Scenic City Rheumatology, PLLC CurrentSince Oct 1, 2005 Accepting new patients
Arthritis Associates PLLC Past Accepting new patients
Ut Physicians Inc Past Accepting new patients

Locations

6145 Shallowford Rd
Ste 102
Chattanooga, TN 37421
Phone (423) 893-6890

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 5

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1568564672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6145 SHALLOWFORD RD",
            "address_2": "STE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-893-6890",
            "fax_number": "423-648-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6145 SHALLOWFORD RD",
            "address_2": "STE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-893-6890",
            "fax_number": "423-648-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "RICHARD",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TN",
            "license": "16562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4110715",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3731246",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.