Healthcare Provider Details

I. General information

NPI: 1023022084
Provider Name (Legal Business Name): DAYSPRING HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 SUNSET TRL
JELLICO TN
37762
US

IV. Provider business mailing address

107 S MAIN ST P.O. BOX 540
JELLICO TN
37762-2154
US

V. Phone/Fax

Practice location:
  • Phone: 423-784-5771
  • Fax: 423-784-6185
Mailing address:
  • Phone: 423-784-8492
  • Fax: 423-784-8358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number43450
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number441853
License Number StateTN

VIII. Authorized Official

Name: MR. GEOGY THOMAS
Title or Position: CEO
Credential: MD
Phone: 423-784-8492