DR. NELLIE PATRICIA GANNON (NPI# 1710480876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710480876 |
| Entity Type | Individual |
| Full Name | DR. NELLIE PATRICIA GANNON |
| Credential | DMD |
| Practice Address |
615 Derby St Chattanooga TN 37404-1632 |
| Mailing Address |
20 Cherokee Blvd Apt 406 Chattanooga TN 37405-4454 |
| Practice Telephone | 4236649432 |
| Mailing Telephone | 7082544160 |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2020-04-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.031842 | IL | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4501 Louise Underwood Way, Louisville, KY 402163987 | 7082544160 |
| Street Address |
615 DERBY ST |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37404-1632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881696417 | Laura L Porter | Nurse Practitioner | 615 Derby St, Attention: Hcs Hi&r, Chattanooga, TN 37404-1632 | 2005-08-12 |
| 1326434663 | Amy Jo Schamens | Behavioral Analyst | 615 Derby St, Chattanooga, TN 37404-1632 | 2015-04-14 |
| 1164838058 | Ann Graham Parker | Psychologist | 615 Derby St, Chattanooga, TN 37404-1632 | 2014-07-11 |
| 1356694921 | Orange Grove Center, Inc Brown Chapel | Intermediate Care Facility, Mentally Retarded | 615 Derby St, Chattanooga, TN 37404-1632 | 2012-10-19 |
| 1770836330 | Orange Grove Center, Inc 5345 Mountain Creek | Intermediate Care Facility, Mentally Retarded | 615 Derby St, Chattanooga, TN 37404-1632 | 2012-10-19 |
| 1114294600 | Orange Grove Center, Inc. | Day Training, Developmentally Disabled Services | 615 Derby St, Chattanooga, TN 37404-1632 | 2011-11-28 |
| 1225315161 | Orange Grove Center, Inc 7445 Pinewood Dr | Intermediate Care Facility, Mentally Retarded | 615 Derby St, Chattanooga, TN 37404-1632 | 2011-11-07 |
| 1952688897 | Orange Grove Center, Inc 7447 Pinewood Dr | Intermediate Care Facility, Mentally Retarded | 615 Derby St, Chattanooga, TN 37404-1632 | 2011-11-07 |
| 1841575180 | Donna Eileen Leath | Occupational Therapy Assistant | 615 Derby St, Chattanooga, TN 37404-1632 | 2011-10-19 |
| 1225325483 | Latosha K Walker | Nurse Practitioner | 615 Derby St, Attention: Hcs Hi&r, Chattanooga, TN 37404-1632 | 2011-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306494216 | Cynthia Caffey | Technician | 1305 E. 28th St. Apt A, Chatta, TN 37404 | 2019-09-04 |
| 1851944482 | Stacey Stokes | Peer Specialist | 1413 Bailey Ave, Chattanooga, TN 37404 | 2019-07-23 |
| 1306354790 | Erlanger Behavioral Health, LLC | Psychiatric Hospital | 804 North Holtzclaw Avenue, Chattanooga, TN 37404 | 2018-01-19 |
| 1245746171 | Davis Supportive Living Home Inc. | Custodial Care Facility | 1106 Duncan Avenue, Chattanooga, TN 37404 | 2017-12-14 |
| 1124544762 | Rachael Anne Maciver | Nurse Practitioner | 1909 South Willow Street, Chattanooga, TN 37404 | 2017-08-15 |
| 1447796214 | Esli Castillo | Nurse Practitioner | 281 N.lyerly St., Suite 200, Chattanooga, TN 37404 | 2017-01-17 |
| 1922542158 | Natasha Elliott | Community Health Worker | 2804 Cannon Ave, Chattanooga, TN 37404 | 2016-12-07 |
| 1730630153 | Jonathan Easter | Taxi | 1611 Anderson Avenue, Apt A, Chattanooga, TN 37404 | 2016-10-20 |
| 1477946143 | Thomas Jereme Holcomb | Nurse Practitioner | 281 N. Lyerly St, Suite 200, Chattanooga, TN 37404 | 2015-03-05 |
| 1922426709 | Sarah Mccary Baker | Internal Medicine | 605 Glenwood Drive, Suite 300, Chattanooga Internal Medicine Group, Chattanooga, TN 37404 | 2014-03-31 |
| Find all providers in zip 37404 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093360794 | Dr. Drew Shabo LLC | Dentist | 1309 Panorama Dr, Chattanooga, TN 37421-4770 | 2019-08-08 |
| 1356901946 | Tn Dental Professionals PC | Dentist | 1309 Panorama Dr Ste 101, Chattanooga, TN 37421-4771 | 2019-06-17 |
| 1447743653 | Tyler Fielding Mccubbins | Dentist | 1612 Gunbarrel Rd Ste 102, Chattanooga, TN 37421-4135 | 2018-06-12 |
| 1083134977 | Evan Scott Myers | Dentist | 951 Riverfront Pkwy Ste 101, Chattanooga, TN 37402-2185 | 2017-06-22 |
| 1851829162 | Adam Nathaniel Parker | Dentist | 7030 Lee Hwy Ste 101, Chattanooga, TN 37421-6795 | 2017-05-31 |
| 1770988834 | 32 Dental, LLC | Dentist | 7333 Shallowford Rd, Chattanooga, TN 37421-2627 | 2014-10-30 |
| 1497168579 | Mark S. Cowart, D.d.s. Inc | Dentist | 4355 Highway 58 Ste 103a, Chattanooga, TN 37416-2941 | 2014-06-06 |
| 1447508098 | Frederick H Thompson | Dentist | 4109 Mountain View Ave, Suite 300, Chattanooga, TN 37415-2096 | 2012-08-29 |
| 1699044487 | Constance Chamberlain Wise | Dentist | 4300 Dayton Blvd, Chattanooga, TN 37415 | 2011-12-22 |
| 1316125354 | Mark Stephen Dill | Dentist | 6102 Shallowford Rd Ste 101, Chattanooga, TN 37421-1684 | 2008-02-01 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37404 |
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| 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.