Southern Life Healthcare PLLC
NPI 1538887401 · General Practice Physician · Chattanooga, TN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southern Life Healthcare PLLC is a General Practice Physician organization in Chattanooga, TN (NPI 1538887401).
Provider details
- NPI number
- 1538887401
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ethan Kellum, Medical Director(901) 484-0837
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-08-17
- Last updated
- 2024-06-13
- Certified
- 2024-06-13
Frequently asked questions
- What is Southern Life Healthcare PLLC's NPI number?
- Southern Life Healthcare PLLC's National Provider Identifier (NPI) is 1538887401, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Life Healthcare PLLC?
- Southern Life Healthcare PLLC is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Southern Life Healthcare PLLC located?
- Southern Life Healthcare PLLC's practice location on file with NPPES is 6102 Shallowford Rd Ste 104, Chattanooga, TN 37421-1684.
- What is Southern Life Healthcare PLLC's phone number?
- The practice phone number listed in the NPPES registry for Southern Life Healthcare PLLC is (423) 443-6400.
- Does Southern Life Healthcare PLLC accept Medicare?
- Southern Life Healthcare PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southern Life Healthcare PLLC?
- The authorized official listed on Southern Life Healthcare PLLC's NPPES record is Ethan Kellum, Medical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Life Healthcare PLLC's NPI active?
- Yes — Southern Life Healthcare PLLC's NPI (1538887401) is active in the NPPES registry as of the last update on 2024-06-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.