Individual provider Active NPI

Gregory C Schrader, DC

  • Chiropractor
  • Ooltewah, TN
National Provider Identifier
1568708261
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC1767 Issued in TN
Practice address
9457 David Smith LN
Ooltewah, TN 37363-7292
Phone
(423) 238-4118
Fax
(423) 238-6565
NPI assigned
Dec 27, 2012
Last updated
Sep 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC1767 TN Primary

Addresses

Primary practice location

9457 David Smith LN
Ooltewah, TN 37363-7292

Mailing address

9457 David Smith LN
Ooltewah, TN 37363-7292
Phone (423) 238-4118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150126001159 TN Practitioner - Chiropractic 8022332949 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9457 David Smith LN
Suite 105
Ooltewah, TN 37363-7205
Phone (423) 238-4118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DC1767TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Collegedale Chiropractic PLLC Chiropractor CurrentSince Mar 21, 2017 Accepting new patients
Collegedale Physical Medicine, PLLC CurrentSince Feb 1, 2022 Accepting new patients

Locations

9457 David Smith Ln
Ste 103
Ooltewah, TN 37363
Phone (423) 238-4118

9457 David Smith Ln
Ste 105
Ooltewah, TN 37363
Phone (423) 238-4118

Organizations & group practices 3

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": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1568708261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9457 DAVID SMITH LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637292",
            "telephone_number": "423-238-4118",
            "fax_number": "423-238-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9457 DAVID SMITH LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637292",
            "telephone_number": "423-238-4118",
            "fax_number": "423-238-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "GREGORY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-27",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC1767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.