Organization Active NPI

Urban Radiance Medical Spa

  • Family Medicine Physician
  • Morristown, TN
National Provider Identifier
1356234272
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
URBAN RADIANCE MEDICAL SPA
Doing business as
Urban Radiance Medical Spa
Practice address
5675 W Andrew Johnson Hwy
Morristown, TN 37814-1031
Phone
(423) 839-0710
Fax
(689) 232-4757
NPI assigned
May 30, 2025
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Heather A Mullins
Title
Practice Manager
Phone
(423) 839-0710

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Primary Care Clinic/Center 261QP2300X NU

Addresses

Primary practice location

5675 W Andrew Johnson Hwy
Morristown, TN 37814-1031

Mailing address

5675 W Andrew Johnson Hwy
Morristown, TN 37814-1031
Phone (423) 839-0710

Other names 1

  • Urban Radiance Medical Spa Doing business as

National Provider Directory

National Provider Directory

Locations

5675 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 839-0710

Practitioners & affiliated clinicians

Practitioners 1

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": "1748563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1356234272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5675 W ANDREW JOHNSON HWY",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378141031",
            "telephone_number": "423-839-0710",
            "fax_number": "689-232-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 W ANDREW JOHNSON HWY",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378141031",
            "telephone_number": "423-839-0710",
            "fax_number": "689-232-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN RADIANCE MEDICAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "423-839-0710"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urban Radiance Medical Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morristown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.