DR. E RACKLEY IVEY M.D. NPI 1568459212

NPI Information

NPI: 1568459212
Provider Name: DR. E RACKLEY IVEY, M.D.
Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Individual

Specialization: Addiction Medicine

PECOS Registration: Yes

Address:
4346 LAKESHORE LN UNIT 304
CHATTANOOGA, TN
ZIP 37415
Phone: (608) 354-3947
Get Directions

DR. E Rackley Ivey, M.D. is an addiction medicine psychiatry neurology in Chattanooga, TN. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine DR. E Rackley Ivey, M.D. NPI is 1568459212. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4346 LAKESHORE LN UNIT 304
CHATTANOOGA, TN
ZIP 37415-169
Phone: (608) 354-3947

The NPI 1568459212 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/27/2005 and was last updated on 3/9/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084F0202X	Psychiatry & Neurology	Forensic Psychiatry	44317-020	WISCONSIN	No
2	2084P0005X	Psychiatry & Neurology	Neurodevelopmental Disabilities	44317-020	WISCONSIN	No
3	2084P0800X	Psychiatry & Neurology	Psychiatry	44317-020	WISCONSIN	No
4	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	44317-020	WISCONSIN	No
5	2084P0805X	Psychiatry & Neurology	Geriatric Psychiatry	0101232074	VIRGINIA	No
6	209800000X	Legal Medicine		44317-020	WISCONSIN	No
7	2084A0401X	Psychiatry & Neurology	Addiction Medicine	44317-020	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	44317-20	OTHER	WISCONSIN	MEDICAL LICENSE
2	0101232074	OTHER	VIRGINIA	MEDICAL LICENSE
3	67772	OTHER	GEORGIA	MEDICAL LICENSE
4	3428920	MEDICAID	WISCONSIN
5	11027179	OTHER		CAQH
6	036-103584	OTHER	ILLINOIS	MEDICAL LICENSE
7	19248	OTHER	SOUTH CAROLINA	MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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