NPIMap

Organization Active NPI

Chattanooga Spine & Sport

  • Physical Therapist
  • Chattanooga, TN
National Provider Identifier
1700055977
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0000004942 Issued in TN
Legal business name
CHATTANOOGA SPINE & SPORT
Practice address
2307 Napier Rd Ste 103
Chattanooga, TN 37421-1827
Phone
(423) 894-9893
Fax
(423) 894-0992
NPI assigned
Feb 21, 2008
Last updated
Feb 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Authorized official

Name
Mr. Loren Heath Perez, MSPT
Title
Owner
Phone
(423) 894-9893

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT0000004942 TN Primary

Addresses

Primary practice location

2307 Napier Rd Ste 103
Chattanooga, TN 37421-1827

Mailing address

2307 Napier Rd Ste 103
Chattanooga, TN 37421-1827
Phone (423) 894-9893

Other identifiers 1

IdentifierTypeStateIssuer
4170264OtherTNBLUECROSS BLUESHIELD

National Provider Directory

National Provider Directory

Locations

1736 Gunbarrel Rd
#B
Chattanooga, TN 37421
Phone (423) 894-9893

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1700055977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 NAPIER RD STE 103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211827",
            "telephone_number": "423-894-9893",
            "fax_number": "423-894-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 NAPIER RD STE 103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211827",
            "telephone_number": "423-894-9893",
            "fax_number": "423-894-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTANOOGA SPINE & SPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "HEATH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-894-9893",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000004942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "4170264",
            "state": "TN"
        }
    ],
    "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 Feb 21, 2008; 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.