Your Good Health, LLC
Organization Active NPI Primary Care Clinic/Center · East Ridge, TN
NPI 1386864296 · NPPES record last updated Aug 27, 2007
Key facts
- NPI
- 1386864296
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- APN0000007173 (TN)
- Legal business name
- YOUR GOOD HEALTH, LLC
- Practice address
- 1508 Tombras Ave
East Ridge, TN 37412-2720 - Phone
- (423) 867-4969
- NPI assigned
- Apr 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Laurie Davis, APRN-BC
- Title
- Nurse Practitioner
- Phone
- (423) 867-4969
Practitioners 21
-
Sonia Sue Bible, FNP-BC
-
Carlina Lopez Pendon, FNP-C
-
Judith J Boggess, M.D.
-
Laurie Deanne Davis, FNP-BC
-
Bruce E Dyer Sr., APN
-
Rebecca Dykes Henderson, FNP-BC
-
Jon C Huebschman, MD
-
Gregory Robert Joyner, FNP-C
-
Tami Lyn Lloyd, FNP-C
-
Shanna Magloire Regis, FNP-C
-
Amin Sohani, NP-C
-
John Stewart Carden, PA-C
-
Natalie Kathryn McQueen, PA-C
-
Charles R Larmore, NP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D1069780 | In Good Health | Certificate of waiver | Jun 12, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070825000133 | TN | Part B Supplier - Clinic/Group Practice | 3173615838 |
Receives reassigned benefits from 20 practitioners Practice locations: East Ridge, TN |
| O20080806000348 | GA | Part B Supplier - Clinic/Group Practice | 3173615838 |
Receives reassigned benefits from 5 practitioners Practice locations: Ft Oglethorpe, GA |
National Provider Directory
Locations
7550 Goodwin Rd
Chattanooga, TN 37421
Phone (423) 894-3252
1508 Tombras Ave
East Ridge, TN 37412
Phone (423) 867-4969
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72916
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | APN0000007173 | TN | Yes |
Addresses
Primary practice location
1508 Tombras Ave
East Ridge, TN 37412-2720
Mailing address
1508 Tombras Ave
East Ridge, TN 37412-2720
Phone (423) 867-4969
Other names
- In Good Health
Other providers in East Ridge, TN
All providers in East Ridge, TN · Primary Care Clinic/Center in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.