SCENIC CITY NEUROTHERAPY AND KETAMINE CENTER PC (NPI# 1366077539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366077539 |
| Entity Type | Organization |
| Organization Name | SCENIC CITY NEUROTHERAPY AND KETAMINE CENTER PC |
| Practice Address |
7405 Shallowford Rd Ste 360 Chattanooga TN 37421-2678 |
| Mailing Address |
5751 Uptain Rd. Suite 100 Chattanooga TN 37411-4077 |
| Practice Telephone | 4232280579 |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | CHARLES MILLER (OWNER) |
| Authorized Official Telephone | 4238999080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7405 SHALLOWFORD RD STE 360 |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421-2678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1750921367 | Stephan Ian Belasco | Counselor | 1360 Mackey Branch Dr., Chattanooga, TN 37421 | 2020-01-11 |
| 1932745817 | Sound Living Inc | Community/Behavioral Health | 6727 Heritage Business Court, Suite 720, Chattanooga, TN 37421 | 2019-11-26 |
| 1245875046 | Chattanooga Compounding Pharmacy Inc. | Pharmacy | 7032 East Brainerd Rd, Suite A-b, Chattanooga, TN 37421 | 2019-11-15 |
| 1083105803 | Trauma and Addiction Recovery Center | Counselor | 6727 Heritage Business Ct Ste 718, Chattanooga, TN 37421 | 2018-05-29 |
| 1497257448 | Claude James Bowden | Counselor | 7372 Applegate Lane, Chattanooga, TN 37421 | 2018-03-06 |
| 1093213332 | Preferred Primary Care | Clinic/Center | 6031 Shallowford Rd Ste 105, Chattanooga, TN 37421 | 2018-01-31 |
| 1124526777 | Elizabeth Marie Wright | Nurse Practitioner | 6130 Shallowford Rd Ste 101, Chattanooga, TN 37421 | 2018-01-30 |
| 1477065712 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 7326 Mccutcheon Rd, Chattanooga, TN 37421 | 2017-10-26 |
| 1144746645 | Mobility At Home LLC | Contractor | 6307 E Brainerd Rd, Chattanooga, TN 37421 | 2017-08-16 |
| Find all providers in zip 37421 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366054785 | Jamie Renee Slagle | Nurse Practitioner | 6061 Shallowford Rd, Chattanooga, TN 37421-1688 | 2020-08-18 |
| 1699390757 | Lacy E Cushman | Nurse Practitioner | 1622 Mary Dupre Dr, Chattanooga, TN 37421-2538 | 2020-06-14 |
| 1740839315 | Emmaline Camille Newman | Nurse Practitioner | 1703 W 54th St, Chattanooga, TN 37409-2011 | 2019-09-06 |
| 1215490230 | Tina Michell Carden | Nurse Practitioner | 2200 E 3rd St Ste 100, Chattanooga, TN 37404-2724 | 2019-04-08 |
| 1922568807 | Twelvestone Infusion Centers LLC | Nurse Practitioner | 6150 Shallowford Rd Ste 102, Chattanooga, TN 37421-7218 | 2019-03-25 |
| 1710453436 | Kelly Gayler | Nurse Practitioner | 1751 Gunbarrel Rd Ste 103, Chattanooga, TN 37421-7162 | 2018-10-20 |
| 1043737976 | Sarah K Olds | Nurse Practitioner | 725 Glenwood Dr Ste 780, Chattanooga, TN 37404-1177 | 2017-08-22 |
| 1124544762 | Rachael Anne Maciver | Nurse Practitioner | 1909 South Willow Street, Chattanooga, TN 37404 | 2017-08-15 |
| 1457875064 | Riverview Medical Services | Nurse Practitioner | 6148 Lee Highway, Suite 107, Chattanooga, TN 37421 | 2017-07-26 |
| 1447796214 | Esli Castillo | Nurse Practitioner | 281 N.lyerly St., Suite 200, Chattanooga, TN 37404 | 2017-01-17 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37421 |
Please comment or provide details below to improve the information on SCENIC CITY NEUROTHERAPY AND KETAMINE CENTER PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.