East Tennessee Recovery, PLLC

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

EAST TENNESSEE RECOVERY, PLLC

Practice address

2408 Susannah St Ste 1
Johnson City, TN 37601-1765

Phone

(423) 434-6677

Fax

(423) 461-0000

NPI assigned

Dec 27, 2016

Last updated

Dec 16, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel Tackling

Title

Cfo

Phone

(423) 434-6677

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• New Life Medicine Former legal business name

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 28

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.

• Jason J Della Vecchia, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Kingsport, TN
  • NPI 1770554982

  VA

  Medicare reassignment Care Compare group NPD
• Marianne E Filka, MD

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1174525307

  Addiction Medicine, VA

  Medicare reassignment Care Compare group NPD
• Rebecca Dian Greenway, LCSW

  • Clinical Social Worker
  • Johnson City, TN
  • NPI 1174709323

  VA

  Medicare reassignment Care Compare group NPD
• Emmalea Elizabeth Johnston, NP-C

  • Family Nurse Practitioner
  • Johnson City, TN
  • NPI 1073891701

  VA

  Medicare reassignment Care Compare group NPD
• Carrie N. Lingerfelt, FNP/ CNM

  • Family Nurse Practitioner
  • Johnson City, TN
  • NPI 1497784136
  Medicare reassignment Care Compare group NPD
• Ashlyn Nicole Morehouse

  • Nurse Practitioner
  • Johnson City, TN
  • NPI 1962126128
  Medicare reassignment Care Compare group NPD
• Jared W Pack, DO

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1396163101
  Medicare reassignment Care Compare group NPD
• Christy J Smith, APN

  • Family Nurse Practitioner
  • Johnson City, TN
  • NPI 1316117013

  VA

  Medicare reassignment Care Compare group NPD
• Michaela Afton Barnes

  • Professional Counselor
  • Richlands, VA
  • NPI 1114410016

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Latoshia Renee Belcher, LPC

  • Professional Counselor
  • Bristol, VA
  • NPI 1588276547

  TN

  Medicare reassignment Care Compare group NPD
• Aleshia Grizzle, FNP

  • Family Nurse Practitioner
  • Grundy, VA
  • NPI 1902795552
  Medicare reassignment Care Compare group NPD
• Alyson Paige Meadows, MSN, FNP-C

  • Family Nurse Practitioner
  • Grundy, VA
  • NPI 1982446514
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1114462215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 SUSANNAH ST STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011765",
            "telephone_number": "423-434-6677",
            "fax_number": "423-461-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 SUSANNAH ST STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011765",
            "telephone_number": "423-434-6677",
            "fax_number": "423-461-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18948 US Highway 58",
            "address_purpose": "LOCATION",
            "city": "Castlewood",
            "state": "VA",
            "postal_code": "242246032",
            "country_code": "US",
            "telephone_number": "276-762-2172",
            "fax_number": "276-762-5039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19380 US Highway 58",
            "address_purpose": "LOCATION",
            "city": "Castlewood",
            "state": "VA",
            "postal_code": "24224",
            "country_code": "US",
            "telephone_number": "276-762-2172",
            "fax_number": "276-762-5039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2011 2nd St",
            "address_purpose": "LOCATION",
            "city": "Richlands",
            "state": "VA",
            "postal_code": "246412305",
            "country_code": "US",
            "telephone_number": "276-345-9900",
            "fax_number": "276-345-9901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1662 Bonham Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "VA",
            "postal_code": "242012090",
            "country_code": "US",
            "telephone_number": "276-644-9899",
            "fax_number": "276-644-9978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "137 Court St SE",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242103305",
            "country_code": "US",
            "telephone_number": "276-477-1400",
            "fax_number": "276-477-1401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1725 Park Ave SW",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731608",
            "country_code": "US",
            "telephone_number": "276-409-5922",
            "fax_number": "276-409-5923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST TENNESSEE RECOVERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "TACKLING",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "423-434-6677"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100519480",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q026013",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017139831",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Life Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New Life Medicine",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• East Tennessee State University (Northside Elementary School Clinic)

• Addiction Medicine (Internal Medicine) Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Addiction Medicine (Internal Medicine) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.