PHOENIX HEALTH PLLC (NPI# 1649835398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649835398 |
| Entity Type | Organization |
| Organization Name | PHOENIX HEALTH PLLC |
| Practice Address |
7011 Shallowford Rd Ste 104 Chattanooga TN 37421-6727 |
| Mailing Address |
5751 Uptain Rd. Suite 100 Chattanooga TN 37411-4077 |
| Practice Telephone | 4232088099 |
| Mailing Telephone | 4238999080 |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |
| Authorized Official Name | JANELLE EDMONDSON (OWNER) |
| Authorized Official Telephone | 4238999080 |
| Authorized Official Credential | PMHNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7011 SHALLOWFORD RD STE 104 |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421-6727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245760347 | Janelle Edmondson | Nurse Practitioner | 7011 Shallowford Rd Ste 104, Chattanooga, TN 37421 | 2017-06-13 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043827041 | Zamaria Davion Louise Gains | Nurse Practitioner | 7405 Shallowford Rd Ste 230, Chattanooga, TN 37421-7632 | 2020-09-24 |
| 1184101743 | Dean Leroy Bowen | Nurse Practitioner | 420 W. Bell Ave., Chattanooga, TN 37405-3404 | 2018-07-25 |
| 1245760347 | Janelle Edmondson | Nurse Practitioner | 7011 Shallowford Rd Ste 104, Chattanooga, TN 37421 | 2017-06-13 |
| 1902275910 | Joshua Thompson | Nurse Practitioner | 804 N Holtzclaw Ave, Chattanooga, TN 37404-1235 | 2015-09-20 |
| 1427238781 | Donna Ward Mccoin | Nurse Practitioner | 420 W Bell Ave, Chattanooga, TN 37405-3404 | 2007-11-05 |
| 1235152372 | Kristy Dunn | Nurse Practitioner | 6400 Lee Hwy Ste 110, Chattanooga, TN 37421-2452 | 2006-07-26 |
| 1487270476 | Keli Michelle Walker | Nurse Practitioner | 420 W Bell Ave, Chattanooga, TN 37405-3404 | 2020-06-25 |
| 1508330150 | Andres Marco Fraga | Nurse Practitioner | 7345 Courage Way, Chattanooga, TN 37421-1555 | 2019-01-16 |
| 1578038576 | Brittany Carmon | Nurse Practitioner | 7345 Courage Way Ste 101, Chattanooga, TN 37421-1555 | 2018-10-06 |
| 1881171627 | Reglindis Parker | Nurse Practitioner | 2205 Mccallie Ave, Chattanooga, TN 37404-3230 | 2018-07-24 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37421 |
Please comment or provide details below to improve the information on PHOENIX HEALTH PLLC.
| 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.