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LIVE WELL MEDICAL CLINIC & SPA
NPI 1902208903
Family Medicine in Monterey, TN

Active since September 22, 2014CLIA Certified · 2 labs
117 W COMMERCIAL AVE, MONTEREY, TN 38574(931) 839-6642(931) 839-6643 Get Directions Write a Review

NPPES record last updated: June 17, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 17, 2025, Jul 3, 2025, Jul 21, 2022 and 1 more (4 updates tracked since 2017).

About Live Well Medical Clinic & Spa NPPES

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

LIVE WELL MEDICAL CLINIC & SPA (NPI 1902208903) is a healthcare organization registered as a family medicine in Monterey, Tennessee and active in the NPI registry since September 2014. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Baxter, and lists Heather Wilson, Owner, as its authorized official.

NPPES Registry Identity

NPI1902208903
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLIVE WELL MEDICAL CLINIC & SPA
Location Address117 W COMMERCIAL AVEMonterey, TN 38574-1107
Mailing Address117 W Commercial AveMonterey, TN 38574-1107 · (931) 839-6642 · Fax (931) 839-6643
Phone(931) 839-6642
Fax(931) 839-6643
Organization SubpartNo
Authorized OfficialHeather WilsonOwner · (931) 839-6642
Enumeration DateSeptember 22, 2014
Last NPPES UpdateJune 17, 20264 updates tracked since enumeration
NPPES CertifiedJune 17, 2026
✔ NPI 1902208903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X
117 W COMMERCIAL AVE, Monterey, TN 38574
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Secondary Practice Location 1

Location 1321 Broad StBaxter, TN 38544-5117 · Phone (931) 839-6642 · Fax (931) 839-6643

Other Identifiers 1

MedicaidQ007973TN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Live Well Medical Clinic & Spa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Live Well Medical Clinic & Spa, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Alyssa Smith, FNP-C
Nurse Practitioner
NPI 1912841479
117 W COMMERCIAL AVE
Monterey, TN 38574
(931) 839-6642
✔ PECOSSame address
Brenda Mcintosh, FNP-C
Nurse Practitioner
NPI 1477863231
117 W COMMERCIAL AVE
Monterey, TN 38574
(931) 839-6642
✔ PECOS0.1 mi
Heather Wilson, GNP
Nurse Practitioner
NPI 1184050262
117 W COMMERCIAL AVE
Monterey, TN 38574
(931) 839-2244
✔ PECOS✔ Accepts Medicare0.1 mi

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 2

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 44D2092526

Live Well Medical Clinic & Spa · Monterey, TN
Active · expires Mar 8, 2027
CLIA Number44D2092526
Laboratory TypePhysician Office
Certificate Effective DateMarch 9, 2025
Certificate Expiration DateMarch 8, 2027
Laboratory DirectorHeather Wilson
Laboratory Phone(931) 839-6642
Laboratory LocationLive Well Medical Clinic & Spa117 West Commercial Ave, Monterey, TN 38574
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 44D2273974

Live Well Medical Clinic & Spa · Baxter, TN
Active · expires Dec 20, 2026
CLIA Number44D2273974
Laboratory TypePhysician Office
Certificate Effective DateDecember 21, 2024
Certificate Expiration DateDecember 20, 2026
Laboratory DirectorHeather Wilson
Laboratory Phone(931) 650-5588
Laboratory LocationLive Well Medical Clinic & Spa321 Broad Street, Baxter, TN 38544
CLIA data matches this NPI record on: Address Name
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 Live Well Medical Clinic & Spa's NPI number?

The NPI number for Live Well Medical Clinic & Spa is 1902208903. It was assigned to this organization in the NPPES registry on September 22, 2014.

Where is Live Well Medical Clinic & Spa located?

Live Well Medical Clinic & Spa is located at 117 W Commercial Ave, Monterey, TN 38574. The listed phone number is (931) 839-6642.

What is Live Well Medical Clinic & Spa's specialty?

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

Is Live Well Medical Clinic & Spa enrolled in Medicare?

Yes. Live Well Medical Clinic & Spa is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Live Well Medical Clinic & Spa?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Live Well Medical Clinic & Spa. 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. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Live Well Medical Clinic & Spa hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Live Well Medical Clinic & Spa was last updated on June 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.