Individual provider Active NPI

Michael Albert Liedke, APRN-BC

  • Acute Care Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1720261365
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
14210 Issued in TN
Practice address
1010 E 3Rd St
Suite 202
Chattanooga, TN 37403-2109
Phone
(423) 265-2233
NPI assigned
Dec 5, 2007
Last updated
Feb 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN185322 GA
Acute Care Nurse Practitioner 363LA2100X RN185322 GA
Acute Care Nurse Practitioner 363LA2100X 14210 TN Primary

Addresses

Primary practice location

1010 E 3Rd St
Suite 202
Chattanooga, TN 37403-2109

Mailing address

1010 E 3Rd St Ste 202
Chattanooga, TN 37403-2174
Phone (423) 265-2233

Other practice location 1

513 Dodds Ave Ste 103
Chattanooga, TN 37404-3909
Phone (423) 698-3423

Other identifiers 1

IdentifierTypeStateIssuer
4310139OtherTNBCBS OF TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221000503 TN Practitioner - Nurse Practitioner 7719065325 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Diagnostic Imaging PCGroup PAC ID 7315848140, 523 clinicians

Practice addresses (Care Compare)

513 Dodds Ave
Suite 103
Chattanooga, TN 37404-3909
Phone (423) 698-3423

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN185322GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority CurrentSince Mar 1, 2015 Accepting new patients
Advanced Diagnostic Imaging, PC Nurse Practitioner CurrentSince Nov 2, 2025 Accepting new patients
Chattanooga Hamilton County Hospital Authority Current Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Mar 1, 2015 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Nov 2, 2025 Accepting new patients

Locations

1010 E 3rd St
Ste 202
Chattanooga, TN 37403
Phone (423) 265-2233

513 Dodds Ave
Ste 103
Chattanooga, TN 37404
Phone (423) 698-3423

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

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

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1720261365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 E 3RD ST STE 202",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032174",
            "telephone_number": "423-265-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E 3RD ST",
            "address_2": "SUITE 202",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032109",
            "telephone_number": "423-265-2233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "513 Dodds Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374043909",
            "country_code": "US",
            "telephone_number": "423-698-3423",
            "fax_number": "423-698-1380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEDKE",
        "first_name": "MICHAEL",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN185322",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN185322",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "14210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4310139",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.