NPIMap

Organization Active NPI

Professional Medical Properties, LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Chattanooga, TN
National Provider Identifier
1700970407
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
PROFESSIONAL MEDICAL PROPERTIES, LLC
Practice address
6015 Shallowford Road
Chattanooga, TN 37421-1688
Phone
(423) 954-9180
Fax
(423) 954-3054
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Authorized official

Name
Dr. Wayne E Tipps, DDSNPI 1154324804
Title
President/Partner
Phone
(423) 893-3333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 1224 TN
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

6015 Shallowford Road
Chattanooga, TN 37421-1688

Mailing address

6015 Shallowford Road
Chattanooga, TN 37421-1688
Phone (423) 893-3333

Other identifiers 1

IdentifierTypeStateIssuer
3287837MedicaidTN

Other names 1

  • Center for Oral Facial and Implant Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

6015 Shallowford Rd
Chattanooga, TN 37421
Phone (423) 893-3333

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522800000000",
    "number": "1700970407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 SHALLOWFORD ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211688",
            "telephone_number": "423-893-3333",
            "fax_number": "423-954-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 SHALLOWFORD ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211688",
            "telephone_number": "423-954-9180",
            "fax_number": "423-954-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL MEDICAL PROPERTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-04-04",
        "status": "A",
        "authorized_official_last_name": "TIPPS",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/PARTNER",
        "authorized_official_telephone_number": "423-893-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "1224",
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3287837",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Oral Facial and Implant Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 4, 2018; 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.