ORANGE GROVE CENTER INC. NPI 1073668653

NPI Information

NPI: 1073668653
Provider Name: ORANGE GROVE CENTER, INC.

Doing Business As: ORANGE GROVE CENTER PRIMARY HEALTH CARE SERVICES

Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
615 DERBY ST
CHATTANOOGA, TN
ZIP 37404
Phone: (423) 493-2905
Get Directions

ORANGE GROVE CENTER, INC. is an adult medicine family medicine in Chattanooga, TN. The provider is definition to come. ORANGE GROVE CENTER, INC. NPI is 1073668653. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Orange Grove Center Primary Health Care Services.

The provider's business location address is:

615 DERBY ST
CHATTANOOGA, TN
ZIP 37404-632
Phone: (423) 493-2905
Fax: (423) 493-2950

The provider's authorized official is Winston K Hauth .
The authorized official title is Ceo and has the following contact phone number (423) 493-2910.

The enumeration date for this NPI number is 1/24/2007 and was last updated on 7/24/2015.

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	1223G0001X	Dentist	General Practice	8686	TENNESSEE	No
2	363LP2300X	Nurse Practitioner	Primary Care	13774	TENNESSEE	No
3	207QA0505X	Family Medicine	Adult Medicine	26723	TENNESSEE	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	3399927	MEDICAID	TENNESSEE
2	CH3763	OTHER	TENNESSEE	RR MEDICARE
3	3070512	OTHER	TENNESSEE	BCBS ID
4	3399927	MEDICARE PIN	TENNESSEE

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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