NPIMap

Organization Active NPI

Your Good Health, LLC

Doing business as In Good Health

  • Primary Care Clinic/Center
  • East Ridge, TN
National Provider Identifier
1386864296
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
APN0000007173 Issued in TN
Legal business name
YOUR GOOD HEALTH, LLC
Doing business as
In Good Health
Practice address
1508 Tombras Ave
East Ridge, TN 37412-2720
Phone
(423) 867-4969
NPI assigned
Apr 26, 2007
Last updated
Aug 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Authorized official

Name
Laurie Davis, APRN-BCNPI 1659332385
Title
Nurse Practitioner
Phone
(423) 867-4969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X APN0000007173 TN Primary

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 1

  • In Good Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D1069780In Good Health1508 Tombras Avenue, East Ridge, TN 37412Certificate of waiverJun 12, 2027

National Provider Directory

National Provider Directory

Locations

5000 Alpha Ln
Hixson, TN 37343
Phone (423) 499-5655

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72916

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1386864296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 TOMBRAS AVE",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374122720",
            "telephone_number": "423-867-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 TOMBRAS AVE",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374122720",
            "telephone_number": "423-867-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR GOOD HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "423-867-4969",
        "authorized_official_credential": "APRN-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "APN0000007173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "In Good Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; 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.