Healthcare Provider Details

I. General information

NPI: 1689509044
Provider Name (Legal Business Name): ATOMIC LEGACY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BRADFORD WAY STE 200
KINGSTON TN
37763-3124
US

IV. Provider business mailing address

1000 BRADFORD WAY STE 200
KINGSTON TN
37763-3124
US

V. Phone/Fax

Practice location:
  • Phone: 865-350-7017
  • Fax: 865-417-3643
Mailing address:
  • Phone: 865-350-7017
  • Fax: 865-417-3643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KAIGAN TAYLOR
Title or Position: OWNER/ ADMINISTRATOR
Credential:
Phone: 865-356-6133