Id Group, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ID GROUP, PLLC

Practice address

1000 East Third Street
Suite 302
Chattanooga, TN 37403-4115

Phone

(423) 664-5165

Fax

(423) 664-5164

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Shauna Wooten

Title

Medical Billing Administrator

Phone

(423) 648-9915

Specialties & licenses 1

Addresses

Other names 1

• The ID Group, PLLC Other name

Medicare fee-for-service enrollment

Enrolled in TN, GA2 enrollments

Enrollment records 2

Locations

Practitioners 5

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

• James Michael Sizemore Jr., MD

  • Infectious Disease Physician
  • Chattanooga, TN
  • NPI 1124021340

  GA

  Medicare reassignment Care Compare group NPD
• Adam James Soufleris, MD

  • Infectious Disease Physician
  • Chattanooga, TN
  • NPI 1184687378
  Medicare reassignment Care Compare group NPD
• Asma N Khatri, MD

  • Infectious Disease Physician
  • Cleveland, TN
  • NPI 1033436837

  GA

  Medicare reassignment NPD
• Janara Jones Huff, MD

  • Pediatric Infectious Diseases Physician
  • Chattanooga, TN
  • NPI 1265467062
  NPD (past)
• Laura Avary Cooley, MD

  • Infectious Disease Physician
  • Atlanta, GA
  • NPI 1306968607
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1891884292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 EAST THIRD STREET",
            "address_2": "SUITE 302",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374034115",
            "telephone_number": "423-664-5165",
            "fax_number": "423-664-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EAST THIRD STREET",
            "address_2": "SUITE 302",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374034115",
            "telephone_number": "423-664-5165",
            "fax_number": "423-664-5164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ID GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "WOOTEN",
        "authorized_official_first_name": "SHAUNA",
        "authorized_official_title_or_position": "MEDICAL BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "423-648-9915"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The ID Group, PLLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The ID Group, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jensen Hart Hyde, MD
• Karissa Hyrchuk, LCSW
• I Am Tiara Mitchell
• Ahmed A Ibrahim, M.D.
• Simon Effat Ibrahim, PTA
• Corey David Idrogo, D.C.
• Osamuyi Idubor, DO
• Samuel Igbinedion
• Veronica Iglesias
• Ignite Chiropractic, LLC

• Specialist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.