Individual provider Active NPI

Donald Paul Hetzel, MD

  • Gastroenterology Physician
  • Chattanooga, TN
National Provider Identifier
1932181245
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
23458 Issued in TN
Practice address
2515 Desales Ave
Suite 206
Chattanooga, TN 37404-1100
Phone
(423) 698-8101
Fax
(423) 698-3450
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 27569 GA
Gastroenterology Physician 207RG0100X 23458 TN Primary

Addresses

Primary practice location

2515 Desales Ave
Suite 206
Chattanooga, TN 37404-1100

Mailing address

1540 Gulf Blvd Unit 2003
Clearwater, FL 33767-2964
Phone (423) 265-0583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27569GAMDGastroenterology Physician
23458TNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1932181245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 GULF BLVD UNIT 2003",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337672964",
            "telephone_number": "423-265-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 DESALES AVE",
            "address_2": "SUITE 206",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041100",
            "telephone_number": "423-698-8101",
            "fax_number": "423-698-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETZEL",
        "first_name": "DONALD",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "27569",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "23458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.