Journey Medical, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

JOURNEY MEDICAL, LLC

Practice address

1406 E Broadway Ste 9
Gallatin, TN 37066-4613

Phone

(615) 675-5093

Fax

(615) 527-7378

NPI assigned

Nov 13, 2023

Last updated

Nov 13, 2023By 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

Mr. Ko San Chan

Title

Manager

Phone

(615) 609-5763

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1356115224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 E BROADWAY STE 9",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370664613",
            "telephone_number": "615-675-5093",
            "fax_number": "615-527-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 E BROADWAY STE 9",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370664613",
            "telephone_number": "615-675-5093",
            "fax_number": "615-527-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEY MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "KO SAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "615-609-5763",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary-Jo Evie Jones, BS
• Alisa Jordan, LCSW
• Deborah Jordan
• Joju Mathews Joseph, MD
• Manu Joseph, P.T.
• Jason L Kastner, MD
• Meredith Rene Keeton, ATC, LAT
• Kayla Marie Kelley
• Lisa S Kellogg, D.O.
• Michael Sean Kellogg, DO

• Substance Use Disorder Rehabilitation Clinic/Center in Gallatin, TN
• Providers in Gallatin, TN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.