| Livingwell Medical Center | |
|
6553 Highway 41 Ringgold GA 30736-2641 | |
| (706) 965-6000 | |
| Not Available |
| Full Name | Livingwell Medical Center |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 6553 Highway 41, Ringgold, Georgia |
| Authorized Official Name and Position | Leslie Weaver (OWNER) |
| Authorized Official Contact | 7069656000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livingwell Medical Center 6553 Highway 41 Ringgold GA 30736-2641 Ph: (706) 965-6000 | Livingwell Medical Center 6553 Highway 41 Ringgold GA 30736-2641 Ph: (706) 965-6000 |
| NPI Number | 1629873492 |
|---|---|
| Provider Enumeration Date | 02/17/2025 |
| Last Update Date | 02/17/2025 |
| Certification Date | 02/17/2025 |
| Medicare PECOS PAC ID | 4385165927 |
|---|---|
| Medicare Enrollment ID | O20250311003054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629873492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 363LF0000X | Nurse Practitioner - Family | () | Primary |
| Provider Name | Stanley M Ireland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023095536 PECOS PAC ID: 4082747100 Enrollment ID: I20100727000049 |
| Provider Name | Leslie M. Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861884512 PECOS PAC ID: 9830282193 Enrollment ID: I20150428000071 |
| Provider Name | Donna E Allison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679061949 PECOS PAC ID: 0143575068 Enrollment ID: I20180618002715 |
| Provider Name | Jeremy L Romine |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457626111 PECOS PAC ID: 9234456690 Enrollment ID: I20200407003861 |
| Provider Name | Chloe M Carson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255279295 PECOS PAC ID: 2961971833 Enrollment ID: I20260520002121 |
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