Individual provider Active NPI

Mary Ann Eck, PA-C

  • Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1609096692
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2539
Practice address
2108 E 3Rd St Ste 200
Chattanooga, TN 37404-2624
Phone
(423) 267-0466
Fax
(423) 493-2371
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2539 Primary
Physician Assistant 363A00000X 0010-00986 NC

Addresses

Primary practice location

2108 E 3Rd St Ste 200
Chattanooga, TN 37404-2624

Mailing address

979 E 3Rd St Ste 300
Chattanooga, TN 37403-2187
Phone (423) 267-0466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2539TNMDFamily Medicine Physician
0010-00986NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Asheville MRI Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1609096692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032187",
            "telephone_number": "423-267-0466",
            "fax_number": "423-493-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 E 3RD ST STE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374042624",
            "telephone_number": "423-267-0466",
            "fax_number": "423-493-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECK",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "PA2539",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00986",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.