NPIMap

Individual provider Active NPI

Derek Logan Crouthers, MD

  • Family Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1962908343
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
63635 Issued in TN
Practice address
3739 Hixson Pike
Chattanooga, TN 37415-3520
Phone
(423) 875-0999
NPI assigned
Apr 4, 2018
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 63635 TN Primary

Addresses

Primary practice location

3739 Hixson Pike
Chattanooga, TN 37415-3520

Mailing address

3739 Hixson Pike
Chattanooga, TN 37415-3520
Phone (423) 875-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210716001669 TN Practitioner - Family Practice 5395098289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Tennessee, HSC, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3739 Hixson Pike
Chattanooga, TN 37415-3520
Phone (423) 875-0999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63635TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation Inc Family Medicine Current Accepting new patients
Memorial Health Partners Foundation Inc Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Memorial Health Partners Foundation, Inc Family Medicine CurrentSince Aug 1, 2021 Accepting new patients

Locations

1949 Gunbarrel Rd
Ste 206
Chattanooga, TN 37421
Phone (423) 495-4345

3739 Hixson Pike
Chattanooga, TN 37415
Phone (423) 875-0999

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

Interoperability endpoints

  • Direct secure messaging: derekcrouthers@tnmhpf.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
CHI Memorial Horton Family Practice Associates-DaytonDayton, TN, CCN 883949 Rural health clinic Corporate Officer Jul 1, 2023
CHI Memorial Family Practice Associates - Spring CitySpring City, TN, CCN 883948 Rural health clinic Corporate Officer Jul 1, 2023
CHI Memorial Family Practice Associates - LafayetteLa Fayette, GA, CCN 118921 Rural health clinic Corporate Officer
Corporate Director
W-2 Managing Employee		 Jul 1, 2023
Jul 1, 2023
Jul 1, 2023

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1962908343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3739 HIXSON PIKE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374153520",
            "telephone_number": "423-875-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3739 HIXSON PIKE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374153520",
            "telephone_number": "423-875-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUTHERS",
        "first_name": "DEREK",
        "middle_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "63635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.