Organization Active NPI

Raydiance, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Erwin, TN
National Provider Identifier
1962203554
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
RAYDIANCE, LLC
Practice address
218 Gay St
Erwin, TN 37650-1230
Phone
(603) 325-5970
Fax
(765) 225-5134
NPI assigned
Mar 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Authorized official

Name
Ms. Alicia Susanne Emery, DNP, FNP-BC, PMHNP-CNPI 1114419728
Title
Owner
Phone
(423) 741-1481

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

218 Gay St
Erwin, TN 37650-1230

Mailing address

218 Gay St
Erwin, TN 37650-1230
Phone (603) 325-5970

Other names 1

  • RAYdiance Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250519002305 TN Part B Supplier - Clinic/Group Practice 0840718359 Receives reassigned benefits from 2 practitioners
Practice locations: Erwin, TN

National Provider Directory

National Provider Directory

Locations

218 Gay St
Erwin, TN 37650

631 Sinasta Dr
Ste 6
Erwin, TN 37650

631 Sinasta Dr
Ste 4B
Erwin, TN 37650
Phone (423) 302-0663

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": "1742428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1962203554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 GAY ST",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501230",
            "telephone_number": "603-325-5970",
            "fax_number": "765-225-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 GAY ST",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501230",
            "telephone_number": "603-325-5970",
            "fax_number": "765-225-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYDIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-20",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "EMERY",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "SUSANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-741-1481",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DNP, FNP-BC, PMHNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAYdiance",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "RAYdiance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 10, 2026; 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.