Individual provider Active NPI

Eve Raburn Wadzinski, MD

  • Pediatrics Physician
  • Dayton, TN
National Provider Identifier
1720275134
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
43543 Issued in TN
Practice address
149 Walnut Grove Church Rd
Dayton, TN 37321-7925
Phone
(423) 775-5512
NPI assigned
Sep 29, 2007
Last updated
Jun 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 43543 TN Primary

Addresses

Primary practice location

149 Walnut Grove Church Rd
Dayton, TN 37321-7925

Mailing address

149 Walnut Grove Church Rd
Dayton, TN 37321-7925
Phone (423) 775-5512

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140102001580 TN Practitioner - Pediatric Medicine 6305074071 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43543TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority Pediatrics CurrentSince Jan 21, 2019 Accepting new patients
Erlanger Health Pediatrics CurrentSince Jul 1, 2023 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Dayton Pediatrics P C Past Accepting new patients
Pediatric Choice LLC Pediatrics Past Accepting new patients

Locations

910 Blackford St
Chattanooga, TN 37403
Phone (423) 778-4044

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

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1191024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1720275134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 WALNUT GROVE CHURCH RD",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373217925",
            "telephone_number": "423-775-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 WALNUT GROVE CHURCH RD",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373217925",
            "telephone_number": "423-775-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADZINSKI",
        "first_name": "EVE",
        "middle_name": "RABURN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-29",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "43543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, TN

Sources for this page

Verify at the official NPI Registry.