OrganizationActive
Foundation Medical, Inc.
NPI 1336636158 · Addiction Medicine (Family Medicine) Physician · Johnson City, TN
Provider details
- NPI number
- 1336636158
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jennifer Good, Facility Director/Owner(423) 202-3008
- License
- 1000000022019 (TN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1730 Old Gray Station Rd
Johnson City, TN 37615-3869
Phone: (423) 202-3008
Fax: (423) 202-7835
Street-level locationGet directions
Mailing address
1730 Old Gray Station Rd
Johnson City, TN 37615-3869
Registry dates
- Enumerated
- 2018-04-17
- Last updated
- 2019-07-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.