NPIMap

Organization Active NPI

Amg Livingston LLC

Doing business as Upper Cumberland Center for Women

  • Advanced Practice Midwife
  • Livingston, TN
National Provider Identifier
1508191909
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Legal business name
AMG LIVINGSTON LLC
Doing business as
Upper Cumberland Center for Women
Practice address
700 W Main St
Livingston, TN 38570-1720
Phone
(931) 823-9970
Fax
(931) 823-9006
NPI assigned
Oct 2, 2009
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Johnetta Traylor
Title
Administrator
Phone
(502) 596-6063

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X Primary
Gynecology Physician 207VG0400X
Obstetrics Physician 207VX0000X

Addresses

Primary practice location

700 W Main St
Livingston, TN 38570-1720

Mailing address

700 W Main St
Livingston, TN 38570-1720
Phone (931) 823-9970

Other identifiers 1

IdentifierTypeStateIssuer
1515654MedicaidTN

Other names 1

  • Upper Cumberland Center for Women Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000923 TN Part B Supplier - Clinic/Group Practice 1052225760 Receives reassigned benefits from 36 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cookeville, TN; Livingston, TN; Celina, TN; Byrdstown, TN

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Family Practice Assc Ga3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1254441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1508191909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W MAIN ST",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385701720",
            "telephone_number": "931-823-9970",
            "fax_number": "931-823-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W MAIN ST",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385701720",
            "telephone_number": "931-823-9970",
            "fax_number": "931-823-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG LIVINGSTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-02",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515654",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upper Cumberland Center for Women",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livingston, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.