JAIME PONCE PORTUGAL, MD (NPI# 1245280023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245280023 |
| Entity Type | Individual |
| Full Name | JAIME PONCE PORTUGAL, MD |
| Credential | MEDICAL DOCTOR |
| Practice Address |
7405 Shallowford Road Suite 160 Chattanooga TN 37421 |
| Mailing Address |
1949 Gunbarrel Road Suite 230 Chattanooga TN 37421 |
| Practice Telephone | 7062786403 |
| Practice Fax Number | 7062780087 |
| Mailing Telephone | (423) 495-4620 |
| Mailing Fax Number | 4234954934 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2017-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 36423 | TN | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 046635 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00815361A | 05 |
| Street Address |
7405 SHALLOWFORD ROAD SUITE 160 |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912968371 | Dennis C. Matzkin | Ophthalmology | 7405 Shallowford Road, Suite 400, Chattanooga, TN 37421 | 2006-03-28 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962822981 | David C. Redd, Md, P.C. | Surgery | 2205 Mccallie Ave Ste 507, Chattanooga, TN 37404-3334 | 2014-04-17 |
| 1134462153 | Rishabh N Shah | Surgery | 1949 Gunbarrel Rd Ste 206, Chattanooga, TN 37421-7133 | 2013-03-27 |
| 1386919934 | Justin Paul Gusching | Surgery | 1405 Cowart St Ste 201, Chattanooga, TN 37408-1127 | 2012-03-15 |
| 1558655803 | John Cavan Huggins | Surgery | 979 E 3rd Street, Ste. 300, Chattanooga, TN 37403-2187 | 2011-06-03 |
| 1659520898 | Nicole Marie Walker | Surgery | 605 Glenwood Dr Ste 103, Chattanooga, TN 37404-1150 | 2008-09-11 |
| 1083815609 | Edgar Leonard Scott Jr. | Surgery | 1300 E 3rd St, Chattanooga, TN 37404 | 2007-05-30 |
| 1316153604 | Darren James Hunt | Surgery | 979 E 3rd St Ste 300, Chattanooga, TN 37403-2187 | 2007-05-15 |
| 1245299551 | Richard Hunter Jennings IIi | Surgery | 721 Glenwood Dr Ste 560, Memorial Medical Building West, Chattanooga, TN 37404-1129 | 2006-03-23 |
| 1134195308 | Edward L Humpert | Surgery | 312 N Crest Rd, Chattanooga, TN 37404-1004 | 2006-02-27 |
| 1962476358 | Vincent Wayne Gardner | Surgery | 1405 Cowart St, Suite 321, Chattanooga, TN 37408-1127 | 2006-02-14 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37421 |
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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.