Active NPI
David F Ellison, DO
- Anesthesiology Physician
- Chattanooga, TN
National Provider Identifier
1750494936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- DO00749
- Practice address
- 975 E 3Rd St
Chattanooga, TN 37403-2103 - Phone
- (423) 778-7806
- Fax
- (423) 778-2360
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | DO00749 | TN | Primary |
Addresses
Primary practice location
975 E 3Rd St
Chattanooga, TN 37403-2103
Mailing address
PO Box 11225
Chattanooga, TN 37401-2225
Phone (423) 892-9483
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3302285 | Medicaid | TN | |
| 3031773 | Other | TN | BLUE CROSS BLUE SHIELD OF TENNESSEE |
| 890550M | Medicaid | NC | |
| 009602430 | Medicaid | AL | |
| 000380047C | Medicaid | GA | |
| 050047705 | Other | TN | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO00749 | TN | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesiology Consultants Exchange, PC | Anesthesiology | Past | Accepting new patients |
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.
-
- Anesthesiology Physician
- Chattanooga, TN
- NPI 1184670218
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212364800000",
"number": "1750494936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11225",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374012225",
"telephone_number": "423-892-9483",
"fax_number": "423-899-0928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 E 3RD ST",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374032103",
"telephone_number": "423-778-7806",
"fax_number": "423-778-2360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "DAVID",
"middle_name": "F",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2008-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TN",
"license": "DO00749",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3302285",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF TENNESSEE",
"identifier": "3031773",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890550M",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009602430",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000380047C",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "050047705",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.