The Walter E. Boehm Birth Defects Center, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

THE WALTER E. BOEHM BIRTH DEFECTS CENTER, INC

Practice address

910 Blackford St
Chattanooga, TN 37403-1405

Phone

(423) 778-2222

Fax

(423) 778-6191

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Sharree Stoker

Title

Executive Director

Phone

(423) 778-2222

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952485385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032103",
            "telephone_number": "423-778-2222",
            "fax_number": "423-778-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BLACKFORD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031405",
            "telephone_number": "423-778-2222",
            "fax_number": "423-778-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WALTER E. BOEHM BIRTH DEFECTS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOKER",
        "authorized_official_first_name": "SHARREE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "423-778-2222"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "4094742",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903251",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Aug 22, 2020; 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.