Individual provider Active NPI

Cameron Alexander Payne, FNP-C

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1730602087
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22822 Issued in TN
Practice address
2200 E 3Rd St Ste 200
Chattanooga, TN 37404-2745
Phone
(423) 643-2500
Fax
(423) 305-7822
NPI assigned
Jul 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22822 TN Primary

Addresses

Primary practice location

2200 E 3Rd St Ste 200
Chattanooga, TN 37404-2745

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 497-5355

Other practice location 1

1651 Gunbarrel Rd Ste 102
Chattanooga, TN 37421-3289
Phone (423) 308-0390

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
I20170914000467 TN Practitioner - Nurse Practitioner 1850665845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Medical Group, PCGroup PAC ID 2668377391, 122 clinicians

Practice addresses (Care Compare)

2515 Desales Ave
Suite 206
Chattanooga, TN 37404-1100
Phone (423) 698-8101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley Polk Walk in Clinic Family CurrentSince Jul 13, 2020 Accepting new patients
Galen Medical Group, PC Family CurrentSince Oct 1, 2022 Accepting new patients
Galen Medical Group PC CurrentSince Apr 9, 2023 Accepting new patients
Gastrointestinal Associates of Cleveland, PC Current Accepting new patients

Locations

1651 Gunbarrel Rd
Ste 102
Chattanooga, TN 37421
Phone (423) 308-0292

1651 Gunbarrel Rd
Ste 302
Chattanooga, TN 37421
Phone (423) 899-2904

2200 E 3rd St
Ste 200
Chattanooga, TN 37404
Phone (423) 643-2500

2515 Desales Ave
Ste 206
Chattanooga, TN 37404
Phone (423) 629-6550

4976 Alpha Ln
Hixson, TN 37343
Phone (423) 308-0280

119 White Water Dr
Ocoee, TN 37361
Phone (423) 299-9435

Organizations & group practices 4

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

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": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1730602087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E 3RD ST STE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374042745",
            "telephone_number": "423-643-2500",
            "fax_number": "423-305-7822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1651 Gunbarrel Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374213289",
            "country_code": "US",
            "telephone_number": "423-308-0390",
            "fax_number": "423-308-0395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "CAMERON",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-19",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.