Katherine Marie Chastain, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3372 Issued in TN

Practice address

2358 Lifestyle Way Ste 212
Chattanooga, TN 37421-2291

Phone

(423) 521-1100

Fax

(421) 521-1200

NPI assigned

Aug 21, 2017

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katherine Marie Fatheree Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Skin Cancer & Cosmetic Dermatology Center, PC

  • Dermatology Physician
  • Dalton, GA
  • NPI 1376605394
  NPD (past)

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1699291724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2358 LIFESTYLE WAY STE 212",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212291",
            "telephone_number": "423-521-1100",
            "fax_number": "421-521-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2358 LIFESTYLE WAY STE 212",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212291",
            "telephone_number": "423-521-1100",
            "fax_number": "421-521-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASTAIN",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer and Cosmetic Dermatology Center PC",
            "address_1": "2358 Lifestyle Way Ste 212",
            "city": "Chattanooga",
            "state": "TN",
            "country_code": "US",
            "postal_code": "374212291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "FATHEREE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher W Chase, MD
• Laura Chase, AGACNP-BC, AGPCNP-BC
• Nathan David Chase, LCPC, CADC
• Shirleen D. Chase, NP
• Farlie Preston Lavon Chastain, LCSW
• Laura Chastain
• Timothy Robert Chastanet
• Emily Jean Chastang, PHARMD
• Chattanooga Allergy Clinic , PLLC
• Chattanooga Anesthesia for Outpatient Surgery, PLLC

• 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 Nov 27, 2023; 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.