Individual provider Active NPI

Philip A Bannor, MD

  • Internal Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1962415299
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35052 Issued in TN
Practice address
7011 Shallowford Rd Ste 106
Chattanooga, TN 37421-6727
Phone
(423) 314-9107
NPI assigned
Aug 15, 2006
Last updated
Mar 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35052 TN Primary

Addresses

Primary practice location

7011 Shallowford Rd Ste 106
Chattanooga, TN 37421-6727

Mailing address

710 Lantana Dr
Smyrna, TN 37167-5875
Phone (423) 314-9107

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050412001186 TN Practitioner - Internal Medicine 5890742720 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35052TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carestar Medical Partners LLC Internal Medicine CurrentSince Jul 29, 2025 Accepting new patients
Page Family Practice, Inc. Past Accepting new patients
Carestar Pharmacy Past Accepting new patients

Locations

7011 Shallowford Rd
Ste 106
Chattanooga, TN 37421
Phone (423) 314-9107

Organizations & group practices 3

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1962415299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 LANTANA DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675875",
            "telephone_number": "423-314-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 SHALLOWFORD RD STE 106",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374216727",
            "telephone_number": "423-314-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNOR",
        "first_name": "PHILIP",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "35052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.