Omni Primary Care Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

OMNI PRIMARY CARE CENTER

Practice address

1000 E 3Rd St
#300
Chattanooga, TN 37403-2106

Phone

(423) 778-8021

NPI assigned

Oct 5, 2009

Organization subpart

No

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

Authorized official

Name

Stacy Ford

Title

Secreatary

Phone

(423) 755-5557

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254700800000",
    "number": "1891020111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "address_2": "EMC #330",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 3RD ST",
            "address_2": "#300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032106",
            "telephone_number": "423-778-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI PRIMARY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-05",
        "last_updated": "2009-10-05",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "SECREATARY",
        "authorized_official_telephone_number": "423-755-5557"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; 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.