Active NPI
Andrew Michael Paul
- Physician Assistant
- Chattanooga, TN
National Provider Identifier
1609462670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 5616 Brainerd Rd
Chattanooga, TN 37411-5374 - Phone
- (423) 265-3561
- Fax
- (423) 265-1364
- NPI assigned
- Dec 14, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | TN | Primary |
Addresses
Primary practice location
5616 Brainerd Rd
Chattanooga, TN 37411-5374
Mailing address
2 Fortunes Way
Signal Mountain, TN 37377-2045
Phone (423) 504-0439
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211220001000 | TN | Practitioner - Physician Assistant | 4688065014 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607904000000",
"number": "1609462670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 FORTUNES WAY",
"city": "SIGNAL MOUNTAIN",
"state": "TN",
"postal_code": "373772045",
"telephone_number": "423-504-0439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5616 BRAINERD RD",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374115374",
"telephone_number": "423-265-3561",
"fax_number": "423-265-1364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "ANDREW",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-14",
"last_updated": "2020-12-14",
"certification_date": "2020-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": null,
"primary": true
}
],
"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 Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.