Organization Active NPI

David C. Redd, MD, P.C.

  • Surgery Physician
  • Chattanooga, TN
National Provider Identifier
1962822981
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C70958 Issued in TN
Legal business name
DAVID C. REDD, MD, P.C.
Practice address
2205 McCallie Ave Ste 507
Chattanooga, TN 37404-3334
Phone
(423) 622-3191
Fax
(423) 622-3192
NPI assigned
Apr 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Authorized official

Name
Mrs. Candy E Redd
Title
Office Managaer
Phone
(423) 622-3191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X C70958 TN Primary

Addresses

Primary practice location

2205 McCallie Ave Ste 507
Chattanooga, TN 37404-3334

Mailing address

2205 McCallie Ave Ste 507
Chattanooga, TN 37404-3334
Phone (423) 622-3191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140512000224 TN Part B Supplier - Clinic/Group Practice 5193958494 Receives reassigned benefits from 1 practitioner
Practice locations: Chattanooga, TN; Lookout MTN, TN

National Provider Directory

National Provider Directory

Locations

400 N Market St
Ste 114
Chattanooga, TN 37405
Phone (423) 551-3400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1962822981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 MCCALLIE AVE STE 507",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043334",
            "telephone_number": "423-622-3191",
            "fax_number": "423-622-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 MCCALLIE AVE STE 507",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043334",
            "telephone_number": "423-622-3191",
            "fax_number": "423-622-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C. REDD, MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-17",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "REDD",
        "authorized_official_first_name": "CANDY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGAER",
        "authorized_official_telephone_number": "423-622-3191",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TN",
            "license": "C70958",
            "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 Apr 17, 2014; 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.