| Liberty Healthcare Partners | |
|
1949 Gunbarrel Rd Ste 303 Chattanooga TN 37421-3486 | |
| (423) 498-5839 | |
| Not Available |
| Full Name | Liberty Healthcare Partners |
|---|---|
| Speciality | General Practice |
| Location | 1949 Gunbarrel Rd Ste 303, Chattanooga, Tennessee |
| Authorized Official Name and Position | Angela Alderson (PRACTICE MANAGER) |
| Authorized Official Contact | 4232907800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Healthcare Partners 1949 Gunbarrel Rd Ste 303 Chattanooga TN 37421-3486 Ph: (423) 498-5839 | Liberty Healthcare Partners 1949 Gunbarrel Rd Ste 303 Chattanooga TN 37421-3486 Ph: (423) 498-5839 |
| NPI Number | 1003529280 |
|---|---|
| Provider Enumeration Date | 01/03/2023 |
| Last Update Date | 01/17/2023 |
| Medicare PECOS PAC ID | 1153792734 |
|---|---|
| Medicare Enrollment ID | O20230118000798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003529280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Vicky L Cooke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912013426 PECOS PAC ID: 0143122689 Enrollment ID: I20040129001024 |
| Provider Name | David Castrilli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033477666 PECOS PAC ID: 6709022312 Enrollment ID: I20150725012676 |
| Provider Name | Jenifer Shiphrah Herra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568858819 PECOS PAC ID: 0042531303 Enrollment ID: I20180815004089 |
| Provider Name | Hannah E Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902276330 PECOS PAC ID: 3173823051 Enrollment ID: I20201208000807 |
| Provider Name | Ellen C Cleland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124525423 PECOS PAC ID: 6406106855 Enrollment ID: I20210910002718 |
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