FOUNDATION MEDICAL, INC.
NPI 1336636158
Family Medicine - Addiction Medicine in Johnson City, TN
NPI Status: Active since April 17, 2018
Contact Information
1730 OLD GRAY STATION RD
JOHNSON CITY, TN
ZIP 37615
Phone: (423) 202-3008
Fax: (423) 202-7835
- Organization
- Family Medicine
- Addiction Medicine
- CLIA Number: 44D2241929
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 11-02-2025
About FOUNDATION MEDICAL, INC.
This page provides the complete NPI Profile along with additional information for Foundation Medical, Inc., a provider established in Johnson City, Tennessee operating as a Family Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1336636158 assigned on April 2018. The practitioner's primary taxonomy code is 207QA0401X with license number 1000000022019 (TN). The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Jennifer Teague Good (Facility Director/owner)
- NPI
- 1336636158
- Provider Name
- FOUNDATION MEDICAL, INC.
- Entity Type
- Organization
- Location Address
- 1730 OLD GRAY STATION RD JOHNSON CITY, TN 37615
- Location Phone
- (423) 202-3008
- Location Fax
- (423) 202-7835
- Mailing Address
- 1730 OLD GRAY STATION RD JOHNSON CITY, TN 37615
- Mailing Phone
- (423) 202-3008
- Mailing Fax
- (423) 202-7835
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-17-2018
- Last Update Date
- 07-24-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine Addiction Medicine
- Taxonomy Code
- 207QA0401X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 1000000022019
- License State
- TN
- Taxonomy Description
- A family medicine physician who specializes in the diagnosis and treatment of addictions.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 44D2241929
- Facility Type
- Practitioner Other
- Certificate Effective Date
- November 03, 2023
- Certificate Expiration Date
- November 02, 2025
- Laboratory Director
- MIRANDA MORETZ
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Foundation Medical, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1336636158, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336636158, enumerated as an "organization" on April 17, 2018.
The provider is located at 1730 OLD GRAY STATION RD JOHNSON CITY, TN 37615 and the phone number is (423) 202-3008.
Family Medicine with taxonomy code 207QA0401X and a focus in Addiction Medicine.
