Genesis Health and Wellness Group

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GENESIS HEALTH AND WELLNESS GROUP

Practice address

607 W Due West Ave
Suite 105
Madison, TN 37115-4431

Phone

(615) 891-4903

Fax

(615) 864-8671

NPI assigned

Aug 8, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Allision Patrice Puckett, MD

Title

Owner

Phone

(615) 585-9305

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1770830804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W DUE WEST AVE",
            "address_2": "SUITE 105",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154431",
            "telephone_number": "615-891-4903",
            "fax_number": "615-864-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W DUE WEST AVE",
            "address_2": "SUITE 105",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154431",
            "telephone_number": "615-891-4903",
            "fax_number": "615-864-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH AND WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "ALLISION",
        "authorized_official_middle_name": "PATRICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-585-9305",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1530899",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sierra Gardner
• Hannah Joy Garton
• Gatehouse Treatment of Tennessee, LLC
• Lucy Dale Chiniche Gatlin
• Peter T. Geleskie, M.D.
• Shavonda Gibson
• Clayton Lee Gilbert, RN
• Danielle Kathryn Gilfert
• Giog Sing T. PO, MD & Divina T. PO, MD,PC
• Diana Nicolae Glasser

• Primary Care Clinic/Center in Madison, TN
• Providers in Madison, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.