Jeremy B. Waddell, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1078 Issued in KY

Practice address

979 East 3Rd Street
Suite 300
Chattanooga, TN 37403-2187

Phone

(423) 267-0466

Fax

(423) 757-0866

NPI assigned

Oct 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Kentucky College of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorial Health Partners Foundation IncGroup PAC ID 8022919570, 458 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Commonspirit Health at Home - Chattanooga Home health agency, Chattanooga, TN, CCN 447506
• Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

Merit-based Incentive Payment System (MIPS)

Final score

94.27 of 100Reported as apm

Quality

92.6

Promoting interoperability

93.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeremywaddell@tnmhpf.allscriptsdirect.net
• Direct secure messaging: jwaddell353269@direct.stlukeshealth.org

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.

• Memorial Health Partners Foundation, Inc

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1922053545
  Medicare reassignment Care Compare group NPD
• Memorial Health Partners Foundation Inc

  • Rural Health Clinic/Center
  • Trenton, GA
  • NPI 1467602482
  NPD
• Memorial Health Partners Foundation Inc

  • Rural Health Clinic/Center
  • La Fayette, GA
  • NPI 1760632780
  NPD
• University Surgical Associates, PLLC

  • Surgery Physician
  • Chattanooga, TN
  • NPI 1972520963
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CHI National Home Care, LLC

  • Home Health Agency
  • Chattanooga, TN
  • NPI 1922362144
  Care Compare affiliation
• Memorial Health Care System Inc.

  • General Acute Care Hospital
  • Hixson, TN
  • NPI 1083778633
  Care Compare affiliation
• Memorial Health Care System Inc.

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1255428736
  Care Compare affiliation

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1649469552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "979 EAST 3RD STREET",
            "address_2": "SUITE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032187",
            "telephone_number": "423-267-0466",
            "fax_number": "423-757-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 EAST 3RD STREET",
            "address_2": "SUITE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032187",
            "telephone_number": "423-267-0466",
            "fax_number": "423-757-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "JEREMY",
        "middle_name": "B.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-16",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1078",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA1078",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00469363",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LAB GRP",
            "identifier": "4000501",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100021560",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICIAD LAB GRP",
            "identifier": "37903705",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tomasz H Voychehovski, M.D.
• Sandra Schmidt Vredeveld, D.PH.
• Natalie Ann Vukmer
• W.E.S Transports LLC
• Heather Ellison Waddell, PHARM D
• Casey M. Waddle, NP
• Wade in the Water Medicine LLC
• Cynthia Wade
• Holly Elizabeth Wade, LCSW
• Jason Daniel Wade, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.
• 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.