NPIMap

Organization Active NPI

Amg - Livingston, LLC

Doing business as Clay County Family Wellness

  • Nurse Practitioner
  • Livingston, TN
National Provider Identifier
1902287097
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
AMG - LIVINGSTON, LLC
Doing business as
Clay County Family Wellness
Oasis Family Wellness
The Livingston Clinic1 more in Other names
Practice address
500 W Main St
Livingston, TN 38570-1718
Phone
(931) 823-5681
Fax
(931) 823-8203
NPI assigned
Jun 15, 2015
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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

500 W Main St
Livingston, TN 38570-1718

Mailing address

PO Box 973
Livingston, TN 38570-0973
Phone (931) 823-4016

Other practice location 1

110 Doctors Dr
Celina, TN 38551-5092
Phone (931) 243-3860

Other practice location 2

4120 Bradford Hicks Dr
Livingston, TN 38570-2213
Phone (931) 823-5603

Other practice location 3

8401 Hwy One Eleven
Byrdstown, TN 38549-6031
Phone (931) 823-9970

Other names 4

  • Clay County Family Wellness Doing business as
  • Oasis Family Wellness Doing business as
  • The Livingston Clinic Doing business as
  • 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.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0316263Amg- Livingston, LLC500 West Main Street, Livingston, TN 38570ComplianceMay 4, 2028
44D0687909Amg-Livingston, LLC4120 Bradford Hicks Drive, Livingston, TN 38570Provider-performed microscopySep 14, 2027
44D0963738Amg-Livingston, LLC110 Doctors Drive, Celina, TN 38551Certificate of waiverMay 31, 2028

National Provider Directory

National Provider Directory
Tax ID family
Amg-Livingston3 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 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1902287097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 973",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385700973",
            "telephone_number": "931-823-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385701718",
            "telephone_number": "931-823-5681",
            "fax_number": "931-823-8203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Celina",
            "state": "TN",
            "postal_code": "385515092",
            "country_code": "US",
            "telephone_number": "931-243-3860",
            "fax_number": "931-243-4607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4120 Bradford Hicks Dr",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "TN",
            "postal_code": "385702213",
            "country_code": "US",
            "telephone_number": "931-823-5603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8401 Hwy One Eleven",
            "address_purpose": "LOCATION",
            "city": "Byrdstown",
            "state": "TN",
            "postal_code": "385496031",
            "country_code": "US",
            "telephone_number": "931-823-9970",
            "fax_number": "931-823-9006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMG - LIVINGSTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "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": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay County Family Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clay County Family Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oasis Family Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Livingston Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.