NPIMap

Individual provider Active NPI

John L Gwin Jr., M.D.

  • Surgery Physician
  • Chattanooga, TN
National Provider Identifier
1861486839
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
24584 Issued in TN
Practice address
721 Glenwood Dr
Suite 553
Chattanooga, TN 37404-1106
Phone
(423) 495-2640
Fax
(423) 495-2644
NPI assigned
Sep 7, 2005
Last updated
Mar 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD24584 TN
Surgery Physician 208600000X 24584 TN Primary

Addresses

Primary practice location

721 Glenwood Dr
Suite 553
Chattanooga, TN 37404-1106

Mailing address

721 Glenwood Dr
Suite 553
Chattanooga, TN 37404-1106
Phone (423) 495-2640

Other identifiers 2

IdentifierTypeStateIssuer
3076991MedicaidTN
4088202OtherTNBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014000384 TN Practitioner - General Surgery 1254391279 Reassigns benefits to 1 organization
Practice locations: Chattanooga, TN

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Yale University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 492-4734

5600 Brainerd Rd
Suite 500
Chattanooga, TN 37411-5371
Phone (423) 414-3586

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue543
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD24584TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation Inc Current Accepting new patients
Memorial Health Partners Foundation Inc CurrentSince Sep 1, 2018 Accepting new patients
Memorial Health Partners Foundation, Inc Surgery CurrentSince Sep 1, 2018 Accepting new patients
University Surgical Associates PC Surgery Past Accepting new patients
University Surgical Associates, PLLC Surgery Past Accepting new patients

Locations

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

721 Glenwood Dr
Ste W553
Chattanooga, TN 37404
Phone (423) 495-2640

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71772
  • Direct secure messaging: jgwin133390@direct.stlukeshealth.org
  • Direct secure messaging: johngwin@tnmhpf.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1861486839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 GLENWOOD DR",
            "address_2": "SUITE 553",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041106",
            "telephone_number": "423-495-2640",
            "fax_number": "423-495-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 GLENWOOD DR",
            "address_2": "SUITE 553",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041106",
            "telephone_number": "423-495-2640",
            "fax_number": "423-495-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWIN",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD24584",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "24584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076991",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4088202",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.