Sentef Medical Center | |
9380 Bradmore Ln Ste 104 Ooltewah TN 37363-4447 | |
(423) 760-4630 | |
(423) 760-4631 |
Full Name | Sentef Medical Center |
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Speciality | Clinic/Center |
Location | 9380 Bradmore Ln Ste 104, Ooltewah, Tennessee |
Authorized Official Name and Position | Jeremy Plaster (PRACTICE MANAGER) |
Authorized Official Contact | 2376046304 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sentef Medical Center 9380 Bradmore Ln Ste 104 Ooltewah TN 37363-4447 Ph: (423) 760-4630 | Sentef Medical Center 9380 Bradmore Ln Ste 104 Ooltewah TN 37363-4447 Ph: (423) 760-4630 |
NPI Number | 1043418742 |
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Provider Enumeration Date | 07/05/2007 |
Last Update Date | 02/04/2025 |
Medicare PECOS PAC ID | 6204094170 |
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Medicare Enrollment ID | O20120313000359 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043418742 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Gerard Karl Mazza |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568504918 PECOS PAC ID: 0244270452 Enrollment ID: I20110307000257 |
Provider Name | Susan Sentef |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770838039 PECOS PAC ID: 2961635693 Enrollment ID: I20140505001739 |
Provider Name | Bruce M Fox |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063858819 PECOS PAC ID: 4385953868 Enrollment ID: I20151023000667 |
Provider Name | Sarah M Faulkner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780144246 PECOS PAC ID: 8224465596 Enrollment ID: I20200226001114 |
Provider Name | Lauren E Walliser |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023597341 PECOS PAC ID: 1153752837 Enrollment ID: I20200513001086 |
Provider Name | Hillary L Templeton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992302038 PECOS PAC ID: 8921410655 Enrollment ID: I20201222000248 |
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