Organization Active NPI

Valley Beautiful Healthcare LLC

  • Family Nurse Practitioner
  • Erwin, TN
National Provider Identifier
1720893548
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
VALLEY BEAUTIFUL HEALTHCARE LLC
Practice address
647 N Main Avenue
Erwin, TN 37650-1319
Phone
(423) 735-3405
Fax
(423) 735-3408
NPI assigned
Feb 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Jennifer Garman
Title
Biller
Phone
(540) 443-6080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

647 N Main Avenue
Erwin, TN 37650-1319

Mailing address

647 N Main Avenue
Erwin, TN 37650
Phone (423) 735-3405

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250916003557 TN Part B Supplier - Clinic/Group Practice 3577067248 Receives reassigned benefits from 2 practitioners
Practice locations: Erwin, TN

National Provider Directory

National Provider Directory

Locations

647 N Main Ave
Erwin, TN 37650
Phone (423) 735-3405

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1720893548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 N MAIN AVENUE",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "37650",
            "telephone_number": "423-735-3405",
            "fax_number": "423-735-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 N MAIN AVENUE",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501319",
            "telephone_number": "423-735-3405",
            "fax_number": "423-735-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY BEAUTIFUL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "GARMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "540-443-6080"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erwin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.