Forever Young Medical Aesthetics and Weight Loss LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FOREVER YOUNG MEDICAL AESTHETICS AND WEIGHT LOSS LLC

Practice address

102 Professional Park PVT Dr
Kingsport, TN 37663-2287

Phone

(423) 342-3335

NPI assigned

Jun 12, 2023

Organization subpart

No

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

Authorized official

Name

Heather N Williams, FNPNPI 1265769293

Title

FNP/Owner

Phone

(423) 342-3335

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Heather Nicole Williams, F.N.P.

  • Family Nurse Practitioner
  • Johnson City, TN
  • NPI 1265769293
  NPD Authorized official

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1962186072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PROFESSIONAL PARK PVT DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632287",
            "telephone_number": "423-342-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PROFESSIONAL PARK PVT DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632287",
            "telephone_number": "423-342-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER YOUNG MEDICAL AESTHETICS AND WEIGHT LOSS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "FNP/OWNER",
        "authorized_official_telephone_number": "423-342-3335",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darryl Fontaine, MD
• Brittney Barnwell Fontenot, CRNA
• Darrell Fontenot
• Melissa Hope Ford, RN
• Edward Johnson Fore, M.D.
• Sean Curtis Forrest, MD
• Terry L Forrest, M.D.
• Angel Grace Foskey, PA-C
• Kathleen J Foster, MD
• Larry J Foster, M.D.

• Clinic/Center in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.