THE ASSOCIATES OF MEMORIAL MISSION SURGERY CENTER, LLC (NPI# 1740256197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740256197 |
| Entity Type | Organization |
| Organization Name | THE ASSOCIATES OF MEMORIAL MISSION SURGERY CENTER, LLC |
| Practice Address |
2515 Desales Ave Chattanooga TN 37404-1100 |
| Mailing Address |
Po Box 23785 Chattanooga TN 37422-3785 |
| Practice Telephone | 4236486672 |
| Practice Fax Number | 4236485312 |
| Mailing Telephone | 4236486672 |
| Mailing Fax Number | 4236485312 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2009-03-12 |
| Authorized Official Name | DR. ALAN SHIKOH (CHAIRMAN OF THE BOARD) |
| Authorized Official Telephone | 4236486672 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
147 | TN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 261507535A | 05 | |
| TN | 3288753 | 05 | |
| TN | BCBS OF TN | 4053703 | 01 |
| Street Address |
2515 DESALES AVE |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37404-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932181245 | Donald Paul Hetzel | Internal Medicine | 2515 Desales Ave, Suite 206, Chattanooga, TN 37404-1100 | 2005-11-14 |
| 1316226616 | Shannon Higgins Faires | Nurse Practitioner | 2515 Desales Ave, Suite 206, Chattanooga, TN 37404-1100 | 2011-08-04 |
| 1306036447 | William M Cooney | Internal Medicine | 2515 Desales Ave, Ste 206, Chattanooga, TN 37404-1100 | 2007-07-25 |
| 1154421428 | Vascular Associates, PC | Surgery | 2515 Desales Ave, Suite 206, Chattanooga, TN 37404-1100 | 2006-09-25 |
| 1710080973 | Digestive Health Associates, PC | Internal Medicine | 2515 Desales Ave, Suite 206, Chattanooga, TN 37404-1100 | 2006-09-06 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255386348 | Surgery Center of Chattanooga Lp | Clinic/Center | 400 N Holtzclaw Ave, Chattanooga, TN 37404-1916 | 2006-05-24 |
| 1003861998 | Physicians Surgery Center of Chattanooga, LLC | Clinic/Center | 924 Spring Creek Road, Chattanooga, TN 37412-3910 | 2006-05-23 |
| 1447223938 | Chattanooga Endoscopy Asc LLC | Clinic/Center | 1501 Riverside Drive, Suite 117, Chattanooga, TN 37406-4332 | 2006-02-07 |
| 1801890173 | Novamed Surgery Center of Chattanooga LLC | Clinic/Center | 7305 Jarnigan Rd Ste 200, Chattanooga, TN 37421-4876 | 2005-06-02 |
| 1902415490 | Basket Medical Pllc | Clinic/Center | 6221 Shallowford Rd Ste 100, Chattanooga, TN 37421-1972 | 2020-07-30 |
| 1881962348 | Center for Spine and Pain Medicine PC | Clinic/Center | 7446 Shallowford Rd, Suite 102, Chattanooga, TN 37421-8815 | 2011-12-12 |
| 1841589116 | Renaissance Surgery Center of Chattanooga, LLC | Clinic/Center | 1801 Gunbarrel Rd, Chattanooga, TN 37421-3130 | 2011-04-07 |
| 1326112582 | Tennessee Institute for Maxillofacial Surgery, LLC | Clinic/Center | 625 Morrison Springs Rd, Chattanooga, TN 37415-3401 | 2006-11-20 |
| 1720041254 | Atrium Surgery Center, Ltd., A Tennessee Limited Partnership | Clinic/Center | 1949 Gunbarrel Rd, Suite 290, Chattanooga, TN 37421-3188 | 2006-04-07 |
| 1265438303 | Eye Surgery Center of Chattanooga, LLC | Clinic/Center | 7268 Jarnigan Rd, Ste 104, Chattanooga, TN 37421-3096 | 2005-06-23 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37404 |
Please comment or provide details below to improve the information on THE ASSOCIATES OF MEMORIAL MISSION SURGERY CENTER, LLC.
| 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.