JEREMY B. WADDELL (NPI# 1649469552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649469552 |
| Entity Type | Individual |
| Full Name | JEREMY B. WADDELL |
| Credential | P.A.-C. |
| Practice Address |
979 East 3rd Street Suite 300 Chattanooga TN 37403-2187 |
| Practice Telephone | 4232670466 |
| Practice Fax Number | 4237570866 |
| Mailing Telephone | 4232670466 |
| Mailing Fax Number | 4237570866 |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2010-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1078 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA1078 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MEDICIAD LAB GRP | 37903705 | 01 |
| KY | 7100021560 | 05 | |
| KY | MEDICARE LAB GRP | 4000501 | 01 |
| KY | RR MEDICARE PIN | P00469363 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881097624 | Jeremy Waddell | Nurse Practitioner | 8914a Reed Dr, Emerald Isle, NC 28594-2462 | 2014-10-08 |
| 1235541244 | Jeremy Michael Waddell | Counselor | 1308 N Main Street, Crown Point, IN 46307 | 2014-05-25 |
| Street Address |
979 EAST 3RD STREET SUITE 300 |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37403-2187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093184228 | Carley A Morgan | Nurse Practitioner | 979 East 3rd Street, Suite A440, Chattanooga, TN 37403-2136 | 2015-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033771332 | Jaimie Mills | Specialist/Technologist | 103 Metropolitan Building, Chattanooga, TN 37403 | 2019-07-08 |
| 1972092849 | Joshua Dale Gebhardt | Marriage & Family Therapist | 1024 East M L King Blvd, Chattanooga, TN 37403 | 2018-05-07 |
| 1528580750 | Klifford Hawkins | Physical Therapist | 1100 E 3rd St Ste G103, Chattanooga, TN 37403 | 2017-07-10 |
| 1861921470 | Jonathan Everett Burden | Student in an Organized Health Care Education/Training Program | 960 E 3rd St Ste 104, Chattanooga, TN 37403 | 2017-06-07 |
| 1992167092 | Majel Victoria Purvis Miles | Student in an Organized Health Care Education/Training Program | 979 E 3rd St Ste 401, Chattanooga, TN 37403 | 2016-03-28 |
| 1972942902 | Danielle Nessly | Nurse Practitioner | 730 East 11th Street, Chattanooga, TN 37403 | 2013-06-24 |
| 1023453271 | Nathan Claydon | Internal Medicine | 960 East 3rd St, Suite 104, Chattanooga, TN 37403 | 2013-05-01 |
| 1336482603 | Veronica Patterson Zachry | Student in an Organized Health Care Education/Training Program | 975 E. 3rd Street, Chattanooga, TN 37403 | 2013-04-04 |
| 1639420417 | Ctr. for Individual & Family Effectiveness | Community/Behavioral Health | 310 E. 8th St., Ste. C, Chattanooga, TN 37403 | 2012-09-20 |
| 1063773521 | Shelley L Murphy | Emergency Medicine | 1018 Blackford Street, Chattanooga, TN 37403 | 2012-05-31 |
| Find all providers in zip 37403 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1174008759 | Melissa Ann Hart | Physician Assistant | 2518 Waterhaven Dr, Chattanooga, TN 37406-1143 | 2018-09-28 |
| 1124510193 | Carter Alexis Pieper | Physician Assistant | 961 Spring Creek Rd Ste 100, Chattanooga, TN 37412-3959 | 2018-06-05 |
| 1306352844 | Anne Marie Medved | Physician Assistant | 1185 Mountain Creek Rd Apt 1410, Chattanooga, TN 37405-1657 | 2017-12-20 |
| 1225577190 | Stephanie Ford Mcallister | Physician Assistant | 7446 Shallowford Rd Ste 104, Chattanooga, TN 37421-8817 | 2017-02-13 |
| 1386182269 | Laura Ann Hixon | Physician Assistant | 901 Riverfront Pkwy Ste 300, Chattanooga, TN 37402-2198 | 2017-02-10 |
| 1407203409 | Hannah James | Physician Assistant | 5616 Brainerd Rd Ste 208, Chattanooga, TN 37411-5376 | 2016-05-19 |
| 1639556970 | Amanda Carleo | Physician Assistant | 6035 Shallowford Rd Ste 101, Chattanooga, TN 37421-1688 | 2015-05-06 |
| 1003200312 | Brittany Cannon | Physician Assistant | 979 E 3rd St Ste G, Chattanooga, TN 37403-2136 | 2015-03-25 |
| 1619368727 | Brittney Viar | Physician Assistant | 2358 Lifestyle Way, Suite 212, Chattanooga, TN 37421-2291 | 2015-02-11 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37403 |
Please comment or provide details below to improve the information on JEREMY B. WADDELL.
| 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.