Parkridge Medical Center, Inc.

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

Legal business name

PARKRIDGE MEDICAL CENTER, INC.

Practice address

2333 McCallie Ave
Chattanooga, TN 37404-3258

Phone

(423) 698-6061

Fax

(423) 493-1208

NPI assigned

Jun 8, 2006

Organization subpart

Yes

Parent organization

PARKRIDGE MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Jay St. Pierre

Title

Cfo

Phone

(423) 493-1293

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• PARKRIDGE MEDICAL CENTER Doing business as

Part of

Parkridge Medical Center

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Parkridge Medical Center, Inc.

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1104874684

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahmed A Ibrahim, M.D.

  • Psychiatry Physician
  • Chattanooga, TN
  • NPI 1407188626
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1831139773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043258",
            "telephone_number": "423-698-6061",
            "fax_number": "423-493-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043258",
            "telephone_number": "423-698-6061",
            "fax_number": "423-493-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKRIDGE MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARKRIDGE MEDICAL CENTER",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "ST. PIERRE",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "423-493-1293"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PPO & HMO",
            "identifier": "134385000",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TNCARE PREMIER/TBH",
            "identifier": "016408012",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044S156",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BLUE CROSS",
            "identifier": "0105827",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARKRIDGE MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Parkridge Medical Center, Inc.
• Parkridge Medical Center, Inc.
• Parkridge Medical Center, Inc.
• Parkridge Medical Center, Inc.
• Parkridge Medical Center, Inc.
• Parkridge Medical Center, Inc.
• Parkridge Medical Center, Inc.
• Parkridge Professionals, Inc
• Andrew Eric Parks, LPC-MHSP
• Dennis G Parks, M.DIV.

• All providers in Chattanooga, TN
• Psychiatric Hospital Unit in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.