Individual provider Active NPI

Nita W Shumaker, MD

  • Pediatrics Physician
  • Hixson, TN
National Provider Identifier
1740245612
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25509 Issued in TN
Practice address
1039 Executive Dr Ste 101
Hixson, TN 37343-7900
Phone
(423) 874-0125
Fax
(423) 874-0154
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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 25509 TN Primary

Addresses

Primary practice location

1039 Executive Dr Ste 101
Hixson, TN 37343-7900

Mailing address

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

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
I20060606000276 TN Practitioner - Pediatric Medicine 6103837281 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Medical Group, PC Pediatrics CurrentSince Mar 6, 2009 Accepting new patients

Locations

5600 Brainerd Rd
Ste 100
Chattanooga, TN 37411
Phone (423) 308-0280

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

1039 Executive Dr
Ste 101
Hixson, TN 37343
Phone (423) 874-0125

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

1039 Executive Dr
#S101
Hixson, TN 37343

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1740245612",
    "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": "1039 EXECUTIVE DR STE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437900",
            "telephone_number": "423-874-0125",
            "fax_number": "423-874-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAKER",
        "first_name": "NITA",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "25509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

Verify at the official NPI Registry.