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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

INNOVATIVE FAMILY CARE, PLLC
NPI 1720345408
Family Medicine in Cookeville, TN

Active since April 18, 2012CLIA 44D2042785 · Waiver
3300 WILLIAMS ENTERPRISE DR STE 1, COOKEVILLE, TN 38506(931) 528-9222(931) 854-0907 Get Directions Write a Review

NPPES record last updated: October 27, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 27, 2026, Dec 6, 2022, Sep 3, 2019 (3 updates tracked since 2019).

About Innovative Family Care, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INNOVATIVE FAMILY CARE, PLLC (NPI 1720345408) is a healthcare organization registered as a family medicine in Cookeville, Tennessee and active in the NPI registry since April 2012. The organization holds a CLIA Waiver certificate valid through April 30, 2027 and lists Kristen Wayne, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1720345408
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameINNOVATIVE FAMILY CARE, PLLC
Location Address3300 WILLIAMS ENTERPRISE DR STE 1Cookeville, TN 38506-4224
Mailing Address3300 Williams Enterprise Dr Ste 1Cookeville, TN 38506-4224 · (931) 528-9222 · Fax (844) 749-3079
Phone(931) 528-9222
Fax(931) 854-0907
Organization SubpartNo
Authorized OfficialKristen WayneBusiness Manager · (931) 528-9222
Enumeration DateApril 18, 2012
Last NPPES UpdateOctober 27, 20263 updates tracked since enumeration
NPPES CertifiedOctober 27, 2026
✔ NPI 1720345408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TN · 23607
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3300 WILLIAMS ENTERPRISE DR STE 1, Cookeville, TN 38506
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Innovative Family Care, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Innovative Family Care, PLLC, which bills Medicare for the services they deliver. Of these, 6 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Matthew King, M.D.
Internal Medicine
NPI 1932101284
3300 WILLIAMS ENTERPRISE DR STE 1
Cookeville, TN 38506
(931) 528-9222
✔ PECOS✔ Accepts MedicareSame address
Kathryn Oheron, FNP-C
Nurse Practitioner
NPI 1154911857
3300 WILLIAMS ENTERPRISE DRIVE SUITE 1
Cookeville, TN 38506
(931) 528-9222
✔ PECOS✔ Accepts MedicareSame address
Sandra Thompson, FNP
Nurse Practitioner
NPI 1992715874
3300 WILLIAMS ENTERPRISE DR SUITE 1
Cookeville, TN 38506
(931) 528-9222
✔ PECOS✔ Accepts MedicareSame address
Addison Wright, FNP-BC
Nurse Practitioner
NPI 1760206601
3300 WILLIAMS ENTERPRISE DR STE 1
Cookeville, TN 38506
(931) 528-9222
✔ PECOS✔ Accepts MedicareSame address
Chet Gentry, MD
Family Practice
NPI 1851380406
3300 WILLIAMS ENTERPRISE DR
Cookeville, TN 38506
(931) 528-9222
✔ PECOS✔ Accepts MedicareSame address
Lisa Dillon, FNP-C
Nurse Practitioner
NPI 1962360982
3300 WILLIAMS ENTERPRISE DR
Cookeville, TN 38506
(931) 528-9222
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2042785

Innovative Family Care PLLC · Cookeville, TN
Active · expires Apr 30, 2027
CLIA Number44D2042785
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2025
Certificate Expiration DateApril 30, 2027
Laboratory DirectorDr. Chet M. Gentry
Laboratory Phone(931) 528-9222
Laboratory LocationInnovative Family Care PLLC3300 Williams Enterprise Dr Ste 1, Cookeville, TN 38506
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Innovative Family Care, PLLC's NPI number?

The NPI number for Innovative Family Care, PLLC is 1720345408. It was assigned to this organization in the NPPES registry on April 18, 2012.

Where is Innovative Family Care, PLLC located?

Innovative Family Care, PLLC is located at 3300 Williams Enterprise Dr Ste 1, Cookeville, TN 38506. The listed phone number is (931) 528-9222.

What is Innovative Family Care, PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Innovative Family Care, PLLC enrolled in Medicare?

Yes. Innovative Family Care, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Innovative Family Care, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Innovative Family Care, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4), Family Practice (1) and Internal Medicine (1). Of these, 6 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Innovative Family Care, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2042785) is associated with this NPI, valid through April 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Innovative Family Care, PLLC was last updated on October 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.