NPIMap

Organization Active NPI

Special Care Podiatry of Tennessee, LLC

  • Podiatrist
  • Chattanooga, TN
National Provider Identifier
1780072371
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SPECIAL CARE PODIATRY OF TENNESSEE, LLC
Practice address
6140 E Brainerd Rd
Chattanooga, TN 37421-3910
Phone
(855) 259-9183
Fax
(502) 254-4086
NPI assigned
Jan 5, 2015
Last updated
Jan 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Authorized official

Name
Irma Wejuli, DPMNPI 1083842637
Title
Owner
Phone
(855) 259-9183

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

6140 E Brainerd Rd
Chattanooga, TN 37421-3910

Mailing address

12910 Shelbyville Rd Ste 300
Louisville, KY 40243-2404
Phone (502) 244-2441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151130001704 TN Part B Supplier - Clinic/Group Practice 8820398696 Receives reassigned benefits from 13 practitioners
Practice locations: Chattanooga, TN; Smyrna, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1780072371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 SHELBYVILLE RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432404",
            "telephone_number": "502-244-2441",
            "fax_number": "502-254-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 E BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213910",
            "telephone_number": "855-259-9183",
            "fax_number": "502-254-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL CARE PODIATRY OF TENNESSEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "WEJULI",
        "authorized_official_first_name": "IRMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-259-9183",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.