1053395780 NPI number — STUBBS PROSTHETICS & ORTHOTICS, INC.

Table of content: JAMES CATLIN LPC, NCC (NPI 1023447687)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053395780 NPI number — STUBBS PROSTHETICS & ORTHOTICS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STUBBS PROSTHETICS & ORTHOTICS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053395780
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5715 UPTAIN RD
Provider Second Line Business Mailing Address:
SUITE 5800
Provider Business Mailing Address City Name:
CHATTANOOGA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37411-5511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-698-1778
Provider Business Mailing Address Fax Number:
423-698-1741

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5715 UPTAIN RD
Provider Second Line Business Practice Location Address:
SUITE 5800
Provider Business Practice Location Address City Name:
CHATTANOOGA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37411-5511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-698-1778
Provider Business Practice Location Address Fax Number:
423-698-1741
Provider Enumeration Date:
12/06/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STUBBS
Authorized Official First Name:
MELANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
423-698-1778

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3541423 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000244483A . This is a "MEDICAID" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 15523 . This is a "BCBST" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".