NPIMap

Organization Active NPI

Heal U, LLC

  • Registered Dietitian
  • Johnson City, TN
National Provider Identifier
1396219341
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
HEAL U, LLC
Practice address
2866 Carroll Creek Rd
Johnson City, TN 37615-4541
Phone
(423) 791-5016
NPI assigned
Jan 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Authorized official

Name
Amber Gourley, MS, RDN, CDENPI 1760814271
Title
Owner / Dietitian
Phone
(423) 791-5016

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
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

2866 Carroll Creek Rd
Johnson City, TN 37615-4541

Mailing address

2866 Carroll Creek Rd
Johnson City, TN 37615-4541
Phone (423) 791-5016

Other names 1

  • Heal U Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191007001462 TN Part B Supplier - Clinic/Group Practice 1153652110 Receives reassigned benefits from 3 practitioners
Practice locations: Johnson City, TN; Kingsport, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1547337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569974400000",
    "number": "1396219341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2866 CARROLL CREEK RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154541",
            "telephone_number": "423-791-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2866 CARROLL CREEK RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154541",
            "telephone_number": "423-791-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAL U, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-13",
        "last_updated": "2019-10-02",
        "status": "A",
        "authorized_official_last_name": "GOURLEY",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER / DIETITIAN",
        "authorized_official_telephone_number": "423-791-5016",
        "authorized_official_credential": "MS, RDN, CDE"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heal U",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.