NPIMap

Organization Active NPI

Achieve Health and Wellness

  • Physical Therapy Clinic/Center
  • Gray, TN
National Provider Identifier
1639474745
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
0025661 Issued in TN
Legal business name
ACHIEVE HEALTH AND WELLNESS
Practice address
406 Roy Martin Rd
Suite 9
Gray, TN 37615-2244
Phone
(423) 477-1101
Fax
(423) 477-1102
NPI assigned
Jan 20, 2011
Last updated
Jan 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Authorized official

Name
Mr. Jody Eric Musick, PTNPI 1174826424
Title
Physical Therapist / Owner
Phone
(423) 534-0692

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
Physical Therapy Clinic/Center 261QP2000X 0025661 TN Primary

Addresses

Primary practice location

406 Roy Martin Rd
Suite 9
Gray, TN 37615-2244

Mailing address

406 Roy Martin Rd
Suite 9
Gray, TN 37615-2244
Phone (423) 477-1101

Other practice location 1

110 E Center St
Kingsport, TN 37660-4230
Phone (423) 765-1611

Other identifiers 3

IdentifierTypeStateIssuer
Q004105MedicaidTN
1522471MedicaidTN
4293099OtherTNBCBSTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110316000630 TN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2567644289 Receives reassigned benefits from 5 practitioners
Practice locations: Gray, TN; Kingsport, TN

National Provider Directory

National Provider Directory

Locations

110 E Center St
Kingsport, TN 37660
Phone (423) 477-1101

Practitioners & affiliated clinicians

Practitioners 8

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": "1295481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1639474745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 ROY MARTIN RD",
            "address_2": "SUITE 9",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376152244",
            "telephone_number": "423-477-1101",
            "fax_number": "423-477-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 ROY MARTIN RD",
            "address_2": "SUITE 9",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376152244",
            "telephone_number": "423-477-1101",
            "fax_number": "423-477-1102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 E Center St",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604230",
            "country_code": "US",
            "telephone_number": "423-765-1611",
            "fax_number": "423-765-1612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACHIEVE HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-20",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "MUSICK",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST / OWNER",
        "authorized_official_telephone_number": "423-534-0692",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TN",
            "license": "0025661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q004105",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522471",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN",
            "identifier": "4293099",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gray, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.