Tennessee Center for Regenerative Medicine PC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

TENNESSEE CENTER FOR REGENERATIVE MEDICINE PC

Practice address

1334 Mackey Branch Dr Ste 104
Chattanooga, TN 37421-3471

Phone

(423) 296-2604

Fax

(423) 296-2607

NPI assigned

Aug 19, 2020

Organization subpart

No

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

Authorized official

Name

Jessica Taylor

Title

President

Phone

(423) 718-5380

Specialties & licenses 1

Addresses

Practitioners 1

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

• John Charles Blakely Wall, D.C.

  • Chiropractor
  • Chattanooga, TN
  • NPI 1972694396
  NPD

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1730791963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 MACKEY BRANCH DR STE 104",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213471",
            "telephone_number": "423-296-2604",
            "fax_number": "423-296-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 MACKEY BRANCH DR STE 104",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213471",
            "telephone_number": "423-296-2604",
            "fax_number": "423-296-2607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1745 Phoenix Blvd Ste 335",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303495569",
            "country_code": "US",
            "telephone_number": "423-296-2604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TENNESSEE CENTER FOR REGENERATIVE MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-718-5380"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tennesee Department of Health
• Tennessee Art Therapy and Counseling, LLC
• Tennessee Behavioral Therapy
• Tennessee Cancer Specialists
• Tennessee Cancer Specialists, PLLC
• Tennessee Community Counseling Services, Inc.
• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy LLC

• All providers in Chattanooga, TN
• Adult Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.