Individual provider Active NPI

Jordan McLean Dennett, PA-C

  • Physician Assistant
  • Ooltewah, TN
National Provider Identifier
1861206815
Registry record updated Feb 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4680 Ruby Red Dr Apt 203
Ooltewah, TN 37363-2543
Phone
(434) 851-1756
NPI assigned
Feb 1, 2025
Last updated
Feb 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4680 Ruby Red Dr Apt 203
Ooltewah, TN 37363-2543

Mailing address

4680 Ruby Red Dr Apt 203
Ooltewah, TN 37363-2543
Phone (434) 851-1756

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
I20250919002492 TN Practitioner - Physician Assistant 1557865755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

1751 Gunbarrel Rd
Chattanooga, TN 37421-7162

2600 Taft Hwy
Suite 100
Signal Mountain, TN 37377-2777
Phone (423) 778-9434

632 Morrison Springs Rd
Suite 302
Chattanooga, TN 37415-3402
Phone (423) 778-3358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health CurrentSince Aug 11, 2025 Accepting new patients
Chattanooga Hamilton County Hospital Authority Past Accepting new patients
Chattanooga Hamilton County Hospital Authority Past Accepting new patients

Locations

1751 Gunbarrel Rd
Ste 102
Chattanooga, TN 37421
Phone (423) 778-8536

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1738368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1861206815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4680 RUBY RED DR APT 203",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632543",
            "telephone_number": "434-851-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 RUBY RED DR APT 203",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632543",
            "telephone_number": "434-851-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNETT",
        "first_name": "JORDAN",
        "middle_name": "MCLEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-01",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

Verify at the official NPI Registry.