Individual provider Active NPI

Richard Franklin Mauroner, M.D.

  • Psychiatry Physician
  • Chattanooga, TN
National Provider Identifier
1992813976
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
39384 Issued in TN
Practice address
7155 Lee Hwy Ste 300
Chattanooga, TN 37421-0802
Phone
(423) 648-9290
Fax
(423) 648-9291
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 39384 TN Primary

Addresses

Primary practice location

7155 Lee Hwy Ste 300
Chattanooga, TN 37421-0802

Mailing address

7155 Lee Hwy Ste 300
Chattanooga, TN 37421-0802
Phone (423) 648-9290

Other identifiers 2

IdentifierTypeStateIssuer
4106723OtherTNBLUE CROSS
3334119MedicaidTN

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
I20050921000997 TN Practitioner - Psychiatry 1850340589 Reassigns benefits to 1 organization
Practice locations: Chattanooga, TN

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39384TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faraday Chattanooga PC Psychiatry CurrentSince Aug 21, 2019 Accepting new patients
Columbia Medical Groupdaystar Inc Past Accepting new patients

Locations

6031 Shallowford Rd
Ste 113
Chattanooga, TN 37421
Phone (423) 648-4181

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1992813976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7155 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374210802",
            "telephone_number": "423-648-9290",
            "fax_number": "423-648-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7155 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374210802",
            "telephone_number": "423-648-9290",
            "fax_number": "423-648-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURONER",
        "first_name": "RICHARD",
        "middle_name": "FRANKLIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-03-02",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "39384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4106723",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3334119",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.