Pediatric Health Care Associates, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC HEALTH CARE ASSOCIATES, PC

Practice address

3300 Wilcox Blvd
Chattanooga, TN 37411-1073

Phone

(423) 493-2100

Fax

(423) 493-2148

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Willie Mae Hubbard, MD

Title

Pediatrician/Owner

Phone

(423) 493-2100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NONE Former legal business name

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1750592689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 WILCOX BLVD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374111073",
            "telephone_number": "423-493-2100",
            "fax_number": "423-493-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WILCOX BLVD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374111073",
            "telephone_number": "423-493-2100",
            "fax_number": "423-493-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEALTH CARE ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "PEDIATRICIAN/OWNER",
        "authorized_official_telephone_number": "423-493-2100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1529502",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NONE",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "NONE",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Pediatrics Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.