Foreveryoung Wellness

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

16115 Issued in TN

Legal business name

FOREVERYOUNG WELLNESS

Practice address

5816 Kingston Pike Ste 1
Knoxville, TN 37919-6341

Phone

(865) 444-2130

NPI assigned

Oct 28, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jackie Zgiet, FNP

Title

Ceo

Phone

(865) 444-2130

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1013469725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 KINGSTON PIKE STE 1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379196341",
            "telephone_number": "865-444-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 KINGSTON PIKE STE 1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379196341",
            "telephone_number": "865-444-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVERYOUNG WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "ZGIET",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "865-444-2130",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "16115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1730461666",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Virgil Ford III, M.D.
• Briana Nicole Foreman
• Gregory Foreman, PH.D.
• Myrna Alise Foreman, PA-C
• Forensic Medicine Associates Inc
• Formulab LLC
• Kayla Forren, M.S. CF-SLP
• David A Forsberg, MD
• Amy E Forsee, M.D.
• Thomas Charles Forsythe, PTA

• Primary Care Clinic/Center in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.