Individual provider Active NPI

Autumn Newman, FNP-C

  • Dermatology Physician
  • Hixson, TN
National Provider Identifier
1861946394
Registry record updated Aug 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
21513 Issued in TN
Practice address
2051 Hamill Rd
#301
Hixson, TN 37343-6614
Phone
(423) 870-3376
NPI assigned
Aug 13, 2016
Last updated
Aug 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 21513 TN Primary

Addresses

Primary practice location

2051 Hamill Rd
#301
Hixson, TN 37343-6614

Mailing address

2051 Hamill Rd
#301
Hixson, TN 37343-6614
Phone (423) 870-3376

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
I20161026002760 TN Practitioner - Nurse Practitioner 5799063749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Derm Center PLLCGroup PAC ID 5698143980, 3 clinicians

Practice addresses (Care Compare)

651 E 4TH St
Suite 302
Chattanooga, TN 37403-1935
Phone (423) 977-7546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21513TNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Derm Center, PLLC Dermatology CurrentSince Dec 1, 2023 Accepting new patients

Locations

651 E 4th St
Ste 302
Chattanooga, TN 37403
Phone (423) 977-7546

Organizations & group practices 1

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": "1471046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471046400000",
    "number": "1861946394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 HAMILL RD",
            "address_2": "#301",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373436614",
            "telephone_number": "423-870-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 HAMILL RD",
            "address_2": "#301",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373436614",
            "telephone_number": "423-870-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "AUTUMN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-13",
        "last_updated": "2016-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "21513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

Verify at the official NPI Registry.