Provider Demographics
NPI:1215189956
Name:NEW PARADIGM PLLC
Entity Type:Organization
Organization Name:NEW PARADIGM PLLC
Other - Org Name:HEALTH SOURCE OF CHATTANOOGA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:J
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-475-6464
Mailing Address - Street 1:25 CHEROKEE BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-3838
Mailing Address - Country:US
Mailing Address - Phone:423-475-6464
Mailing Address - Fax:423-475-6458
Practice Address - Street 1:25 CHEROKEE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-3838
Practice Address - Country:US
Practice Address - Phone:423-475-6464
Practice Address - Fax:423-475-6458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002273111N00000X
TNDC0000002342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN36725911Medicare UPIN