Individual provider Active NPI

Varenda Fowler, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1760815484
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
20560 Issued in TN
Practice address
2205 McCallie Ave
Chattanooga, TN 37404
Phone
(423) 267-3455
NPI assigned
Aug 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 20560 TN Primary

Addresses

Primary practice location

2205 McCallie Ave
Chattanooga, TN 37404

Mailing address

2205 McCallie Ave
Chattanooga, TN 37404-3230
Phone (423) 267-3455

Other practice location 1

1083 Boiling Springs Rd
Spartanburg, SC 29303-2248
Phone (864) 583-8647

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
I20200128002140 TN Practitioner - Nurse Practitioner 9436382736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

133 Circlestone Dr
Ringgold, GA 30736-4910

5000 Crossings Cir
Suite 103
Mount Juliet, TN 37122-8591

5751 Uptain Rd
Suite 100
Chattanooga, TN 37111-4077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20560TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Recovery Center of Middle Tennessee, LLC CurrentSince Jan 1, 2024 Accepting new patients
Chattanooga Diagnostic Associates LLC CurrentSince Dec 17, 2019 Accepting new patients
Cedar Recovery of Middle Tennessee, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2205 McCallie Ave
Chattanooga, TN 37404
Phone (423) 508-6733

1512 Hatcher Ln
Columbia, TN 38401
Phone (615) 257-6844

1000 Highway 28
Jasper, TN 37347
Phone (423) 837-9500

2636 N Mount Juliet Rd
Mt Juliet, TN 37122
Phone (615) 680-0110

5000 Crossings Cir
Ste 103
Mt Juliet, TN 37122
Phone (615) 208-9549

2839 Highway 231 N
Ste 101
Shelbyville, TN 37160
Phone (931) 488-4014

Interoperability endpoints

  • Direct secure messaging: varenda.fowler@hca1.eclinicaldirectplus.com

Organizations & group practices 3

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": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1760815484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043230",
            "telephone_number": "423-267-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-267-3455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1083 Boiling Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293032248",
            "country_code": "US",
            "telephone_number": "864-583-8647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "VARENDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "20560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.