Organization Active NPI

My Health, LLC

  • Primary Care Clinic/Center
  • Crossville, TN
National Provider Identifier
1982210233
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MY HEALTH, LLC
Practice address
320 S Main St
Crossville, TN 38555-4838
Phone
(931) 787-1180
Fax
(470) 237-5151
NPI assigned
Sep 22, 2020
Last updated
Nov 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Authorized official

Name
Kindall Berry
Title
Ceo
Phone
(931) 787-8583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

320 S Main St
Crossville, TN 38555-4838

Mailing address

320 S Main St
Crossville, TN 38555-4838
Phone (931) 787-1180

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241230003492 TN Part B Supplier - Clinic/Group Practice 1658808860 Receives reassigned benefits from 1 practitioner
Practice locations: Crossville, TN

National Provider Directory

National Provider Directory

Locations

320 S Main St
Crossville, TN 38555
Phone (931) 787-1170

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1982210233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S MAIN ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554838",
            "telephone_number": "931-787-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S MAIN ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554838",
            "telephone_number": "931-787-1180",
            "fax_number": "470-237-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-22",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "KINDALL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-787-8583"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.