Chattanooga Diagnostic Associates LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CHATTANOOGA DIAGNOSTIC ASSOCIATES LLC

Doing business as

Diagnostic Center

Practice address

2205 McCallie Ave
Chattanooga, TN 37404-3230

Phone

(423) 698-2435

Fax

(423) 697-6110

NPI assigned

Jul 16, 2007

Last updated

Dec 11, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

HTI HOSPITAL HOLDINGS INCAs reported in NPPES

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

Authorized official

Name

Jeff Rydburg

Title

Vice President

Phone

(615) 373-7600

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Diagnostic Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Graham Albert, MD

  • Orthopaedic Surgery of the Spine Physician
  • Chattanooga, TN
  • NPI 1659834083
  Medicare reassignment Care Compare group NPD
• Matthew D Barry, APN

  • Acute Care Nurse Practitioner
  • Chattanooga, TN
  • NPI 1750894978
  Medicare reassignment Care Compare group NPD
• Matthew Stephen Bernard, MD

  • Orthopaedic Surgery Physician
  • Chattanooga, TN
  • NPI 1164632626
  Medicare reassignment Care Compare group NPD
• Adam M Caputo, MD

  • Orthopaedic Surgery of the Spine Physician
  • Chattanooga, TN
  • NPI 1114160678
  Medicare reassignment Care Compare group NPD
• Katherine Grace Henderson, FNP-C

  • Nurse Practitioner
  • Chattanooga, TN
  • NPI 1891560736
  Medicare reassignment Care Compare group NPD
• Matthew Douglas Higgins, M.D.

  • Orthopaedic Surgery Physician
  • Chattanooga, TN
  • NPI 1629205752
  Medicare reassignment Care Compare group NPD
• Ahmed A Ibrahim, M.D.

  • Psychiatry Physician
  • Chattanooga, TN
  • NPI 1407188626
  Medicare reassignment Care Compare group NPD
• Caitlin Alyse Kerley, NP-BC

  • Family Nurse Practitioner
  • Chattanooga, TN
  • NPI 1114458619
  Medicare reassignment Care Compare group NPD
• Stephen Lee Martin, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Chattanooga, TN
  • NPI 1699762146
  Medicare reassignment Care Compare group NPD
• Christopher Pankiw, MD

  • Orthopaedic Surgery Physician
  • Chattanooga, TN
  • NPI 1558667089
  Medicare reassignment Care Compare group NPD
• Richard G Pearce, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Chattanooga, TN
  • NPI 1619942091
  Medicare reassignment Care Compare group NPD
• Danielle Lea Phillips, AGACNP

  • Acute Care Nurse Practitioner
  • Chattanooga, TN
  • NPI 1780077438
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1679772099",
    "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": "423-698-2435",
            "fax_number": "423-697-6110"
        },
        {
            "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": "423-698-2435",
            "fax_number": "423-697-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTANOOGA DIAGNOSTIC ASSOCIATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HTI HOSPITAL HOLDINGS INC",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "RYDBURG",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-373-7600"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3370099",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chattanooga Durable Medical Equipment, LLC
• Chattanooga Ear Nose & Throat Assoc., P.C.
• Chattanooga Emergency Medicine PLLC
• Chattanooga Endoscopy ASC LLC (Chattanooga Endoscopy Center)

• Internal Medicine Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.