Organization Active NPI

Catoosa Behavior Health and Wellness Clinic LLC

  • Family Medicine Physician
  • Ringgold, GA
National Provider Identifier
1073471876
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CATOOSA BEHAVIOR HEALTH AND WELLNESS CLINIC LLC
Practice address
102 RBC Dr
Ringgold, GA 30736-2787
Phone
(404) 937-0561
Fax
(404) 937-0561
NPI assigned
Jan 12, 2026
Last updated
Apr 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Authorized official

Name
Lud Harris, PMHNP
Title
Clinical Director
Phone
(404) 937-0561

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Community Health Clinic/Center 261QC1500X

Addresses

Primary practice location

102 RBC Dr
Ringgold, GA 30736-2787

Mailing address

102 RBC Dr
Ringgold, GA 30736-2787
Phone (404) 937-0561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260516000328 GA Part B Supplier - Clinic/Group Practice 2062981228 Receives reassigned benefits from 1 practitioner
Practice locations: Ringgold, GA

National Provider Directory

National Provider Directory

Locations

102 Rbc Dr
Ringgold, GA 30736
Phone (404) 937-0561

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1073471876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 RBC DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362787",
            "telephone_number": "404-937-0561",
            "fax_number": "404-937-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 RBC DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362787",
            "telephone_number": "404-937-0561",
            "fax_number": "404-937-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATOOSA BEHAVIOR HEALTH AND WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "LUD",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "404-937-0561",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ringgold, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.