| Brainerd Primary Care Pllc | |
|
5109 Brainerd Rd Chattanooga TN 37411-3906 | |
| (423) 777-5900 | |
| Not Available |
| Full Name | Brainerd Primary Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5109 Brainerd Rd, Chattanooga, Tennessee |
| Authorized Official Name and Position | Naveed Hassan Memon (OWNER) |
| Authorized Official Contact | 4234138848 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brainerd Primary Care Pllc Po Box 11492 Chattanooga TN 37401-2492 Ph: () - | Brainerd Primary Care Pllc 5109 Brainerd Rd Chattanooga TN 37411-3906 Ph: (423) 777-5900 |
| NPI Number | 1952049363 |
|---|---|
| Provider Enumeration Date | 05/25/2022 |
| Last Update Date | 05/25/2022 |
| Medicare PECOS PAC ID | 5092194134 |
|---|---|
| Medicare Enrollment ID | O20220621002785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952049363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Naveed H Memon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386609055 PECOS PAC ID: 4688572795 Enrollment ID: I20060503000599 |
| Provider Name | Joy A. Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942694641 PECOS PAC ID: 8729308085 Enrollment ID: I20150528000341 |
| Provider Name | Stacey Lynn Dill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720591514 PECOS PAC ID: 0446510945 Enrollment ID: I20180131003396 |
| Provider Name | Katie Lynn Campos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841795804 PECOS PAC ID: 0244581247 Enrollment ID: I20181001000760 |
| Provider Name | Taylor Jetton Ruyak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710653639 PECOS PAC ID: 7113324260 Enrollment ID: I20210916001681 |
| Provider Name | Jenny R Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093189540 PECOS PAC ID: 6305142092 Enrollment ID: I20240409001664 |
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