HEALTHY LIFE CLINIC, INC. (NPI# 1437389731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437389731 |
| Entity Type | Organization |
| Organization Name | HEALTHY LIFE CLINIC, INC. |
| Practice Address |
110 Perimeter Park Rd. Suite G Knoxville TN 37922-2200 |
| Practice Telephone | 8652476340 |
| Practice Fax Number | 8659512617 |
| Mailing Telephone | 8652476340 |
| Mailing Fax Number | 8659512617 |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2012-01-27 |
| Authorized Official Name | MR. GARY R. BICKFORD (OWNER) |
| Authorized Official Telephone | 8652476340 |
| Authorized Official Credential | FNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN0000012264 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1517282 | 05 |
| Street Address |
110 PERIMETER PARK RD. SUITE G |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37922-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184132185 | Kimberly Zitko | Pharmacist | 400 Goody's Lane, Knoxville, TN 37922 | 2018-01-12 |
| 1366959314 | Matthew Smith | Physician Assistant | 1424 Randall Park Dr, Knoxville, TN 37922 | 2017-12-29 |
| 1174052823 | 24/7 Healthcare, Inc. | Nursing Care | 110 Center Park Drive, Suite 101, Knoxville, TN 37922 | 2017-06-07 |
| 1023543477 | Open Arms Care Corp | Intermediate Care Facility, Mentally Retarded | 12625 S Northshore Dr, Knoxville, TN 37922 | 2017-04-24 |
| 1275905440 | Milligan Surgical Associates, Pllc | Surgery | 1919 Pinnacle Pointe Way, Knoxville, TN 37922 | 2015-10-27 |
| 1275904096 | Medical Necessities & Services LLC | Durable Medical Equipment & Medical Supplies | 9327 S Northshore Dr, Knoxville, TN 37922 | 2015-10-20 |
| 1841668126 | Chad Szala | Behavioral Analyst | 10721 Chapman Hwy #22, Knoxville, TN 37922 | 2015-09-03 |
| 1275916470 | Nikki Nicole Peoples | Acupuncturist | 10406 Jackson Oaks Way Ste A, Knoxville, TN 37922 | 2015-07-07 |
| 1538577747 | Susan Carter | Optometrist | 2053 Thunderhead Rd, Knoxville, TN 37922 | 2014-07-31 |
| 1366868135 | Heartland Infusion | Clinic/Center | 9943 Kingston Pike, Knoxville, TN 37922 | 2014-03-17 |
| Find all providers in zip 37922 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285932 | Caitlyn Lawson | Nurse Practitioner | 7637 Saddlebrooke Dr, Knoxville, TN 37938-4044 | 2020-11-04 |
| 1598371098 | Angela Ruth Porter | Nurse Practitioner | 333 Huxley Rd, Knoxville, TN 37922-3115 | 2020-09-20 |
| 1326653270 | Khalid Khan | Nurse Practitioner | 9036 Highbridge Dr, Knoxville, TN 37922-1439 | 2020-09-08 |
| 1972117042 | Seth Ingebrigtson | Nurse Practitioner | 4707 Seminole Rd, Knoxville, TN 37918-1548 | 2020-09-04 |
| 1013521285 | Ashley Renee Bonnell | Nurse Practitioner | 2667 Sweeping Rain Ln, Knoxville, TN 37931-3170 | 2020-09-03 |
| 1407460207 | Mofoluwasho Adenekan | Nurse Practitioner | 6100 Stratford Park Blvd, Knoxville, TN 37912-2109 | 2020-08-31 |
| 1790395416 | Jessica Moore | Nurse Practitioner | 232 N Watt Rd, Knoxville, TN 37934-1103 | 2020-08-06 |
| 1598375255 | Abbey Rae Powell | Nurse Practitioner | 10119 Tan Rara Dr, Knoxville, TN 37922-4142 | 2020-08-06 |
| 1194335018 | Jennifer Blair Massaro | Nurse Practitioner | 1424 Whitower Dr, Knoxville, TN 37919-8841 | 2020-08-05 |
| 1194333054 | Sara Ann Dajani | Nurse Practitioner | 7600 Redwood Burl Ln, Knoxville, TN 37931-4183 | 2020-07-16 |
| Find all providers in KNOXVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.