NPI Instructions

Information Required for Individual Providers includes: 

 

Provider Name (your full legal name as it appears or will appear on your Social Security Card)

Social Security Number (SS#)

Provider Date of Birth

Country of Birth

State of Birth (if you were born in the U.S.)

Provider Gender

Mailing Address (your local address)

Practice Location Address and Phone Number

 

  Pediatrics Residents should use

       T.C. Thompson Children's Hospital

       910 Blackford Street

       Chattanooga, TN  37403

       Phone:  (423) 778-7000

 

All other residents and fellows should use

       Erlanger Medical Center

       975 East Third Street

       Chattanooga, TN  37403

       Phone:  (423) 778-7000

 

Taxonomy Code (Provider Type) Choose "Student in a Health Care Institution", taxonomy code
       # 390200000X (unless you have a full and unrestricted state license). 
        Most of our residents do not have a full license and are instead covered by a resident
       license exemption, so they will use the 390200000X code.  If you have a full state license,
       select the taxonomy code for the specialty in which you are training.)
 * State License Information (Leave this blank unless you have a full and unrestricted state 
        license.)
  Contact Person Name (Enter your own name here)
  Contact Person Phone Number and Email (Enter your local or cell phone and personal email.)

 

Once you are notified by email of your NPI #, please email it to your Residency Coordinator with a copy to MSE@erlanger.org.

UT College of Medicine Chattanooga     960 East Third Street, Suite 100     Chattanooga, TN 37403     (800)947-7823, ext 6956     info@utcomchatt.org

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