NPIMap

Individual provider Active NPI

Jennifer Ayers Mirza, D.O.

  • Cardiovascular Disease Physician
  • Chattanooga, TN
National Provider Identifier
1659564474
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
DO00000002410 Issued in TN
Practice address
2205 McCallie Ave
Chattanooga, TN 37404-3230
Phone
(423) 508-6733
Fax
(423) 508-6744
NPI assigned
Aug 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 116018700 VA
Cardiovascular Disease Physician 207RC0000X DO00000002410 TN Primary

Addresses

Primary practice location

2205 McCallie Ave
Chattanooga, TN 37404-3230

Mailing address

2205 McCallie Ave
Chattanooga, TN 37404-3230
Phone (423) 508-6733

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
I20130107000060 TN Practitioner - Cardiovascular Disease (Cardiology) 2365505468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
West Virginia School of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

979 E 3Rd St
Chattanooga, TN 37403-2136
Phone (423) 778-5661

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
116018700VAMDInternal Medicine Physician
DO00000002410TNMDCardiovascular Disease Physician
2410TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health Internal Medicine CurrentSince Aug 26, 2023 Accepting new patients
Chattanooga Diagnostic Associates LLC Internal Medicine CurrentSince Dec 15, 2016 Accepting new patients
Erlanger Health CurrentSince Aug 26, 2023 Accepting new patients
Cleveland Medical Clinic Inc Internal Medicine Past Accepting new patients
Chattanooga Hamilton County Hospital Authority Internal Medicine Past Accepting new patients
Norton Community Physician Services LLC Internal Medicine Past Accepting new patients
Norton Community Physician Services LLC Internal Medicine Past Accepting new patients
Erlanger Health Past Accepting new patients

Locations

2205 McCallie Ave
Ste 203
Chattanooga, TN 37404
Phone (423) 622-6848

979 E 3rd St
Ste C520
Chattanooga, TN 37403
Phone (423) 778-4465

2205 McCallie Ave
Ste 102
Chattanooga, TN 37404
Phone (423) 493-5220

2205 McCallie Ave
Chattanooga, TN 37404
Phone (423) 508-6733

195 White Oak Rd
Ste 400
Dayton, TN 37321

1000 Highway 28
Jasper, TN 37347
Phone (423) 837-9500

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Interoperability endpoints

  • Direct secure messaging: jennifer.mirza@hca1.eclinicaldirectplus.com

Organizations & group practices 8

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.

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": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1659564474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043230",
            "telephone_number": "423-508-6733",
            "fax_number": "423-508-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043230",
            "telephone_number": "423-508-6733",
            "fax_number": "423-508-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "JENNIFER",
        "middle_name": "AYERS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "116018700",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "DO00000002410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.