Philip A Bannor, MD
Individual provider Active NPI Internal Medicine Physician · Chattanooga, TN
NPI 1962415299 · NPPES record last updated Mar 20, 2026
Key facts
- NPI
- 1962415299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 35052 (TN)
- Practice address
- 7011 Shallowford Rd Ste 106
Chattanooga, TN 37421-6727 - Phone
- (423) 314-9107
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050412001186 | TN | Practitioner - Internal Medicine | 5890742720 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35052 | TN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carestar Medical Partners LLC | Internal Medicine | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35052 | TN | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3864221 | Medicaid | TN |
Other providers in Chattanooga, TN
- Patricia Maddox Bandy
- Joan Cate Bang
- Rachel Dion Banks
- Samuel L Banks
- Sarah Banks
- Kelli Ruth Banther
- Lacey Banther
- Ashlee Barber
- Brittany Sharp Barber
- Kisha A Barclay
All providers in Chattanooga, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.