Magnolia Health And Wellness LLC
Family Medicine in Carthage, TN. Organization (NPI-2).
NPI number1124906722
StatusActive
Last updated in NPPESSep 30, 2025
Details
- NPI
- 1124906722
- Entity type
- Organization (NPI-2)
- Legal business name
- Magnolia Health And Wellness LLC
- Organization subpart
- No
- Enumeration date
- Aug 22, 2025
- Certification date
- Sep 30, 2025
- Last updated
- Sep 30, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Magnolia Health And Wellness (Former Legal Business Name)
Practice location
516 Main St N # ACarthage, TN 37030-1243
Phone 615-437-0227 · Fax 615-437-0350
Mailing address
516 Main St N # ACarthage, TN 37030-1243
Phone 615-437-0227 · Fax 615-437-0350
Authorized official
Stephanie Ruckman
Owner/Operator
6153089668
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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