OPENING A GLP-1 AND METABOLIC PROGRAM IN NASHVILLE: WHAT TENNESSEE MAKES YOU ANSWER FIRSTTennessee's answers to the ownership question, the staffing question and the telehealth question are not the answers Georgia or Kentucky give, and the differences land in your build schedule and your payroll. This page is general commentary, not legal advice. It is the agenda for a paid hour with a Tennessee healthcare attorney before anything gets signed.

Educational overview · Approx. 9 min read · illustrative, not advice

Tennessee's answers to the ownership question, the staffing question and the telehealth question are not the answers Georgia or Kentucky give, and the differences land in your build schedule and your payroll. This page is general commentary, not legal advice. It is the agenda for a paid hour with a Tennessee healthcare attorney before anything gets signed.

Why Nashville is a Tennessee problem before it is a marketing problem

Buyers arrive at this category thinking the hard part is demand. It is not. Demand for cash-pay metabolic care is broad and reasonably well documented: KFF's national tracking poll fielded October 27 to November 2, 2025 found 18 percent of US adults say they have ever used a GLP-1 drug and 12 percent are currently using one, up six points in current use since May 2024. That is market data. It says nothing about what any operator in Davidson County will do, and Atlas will never pretend otherwise.

The hard part is that the entity delivering care in Tennessee has to be structured the way Tennessee wants it structured, staffed the way Tennessee wants it staffed, and permitted to see a member on a screen before your first campaign runs. Get that sequence backwards and you have a brand and a funnel with nowhere to send anyone.

Atlas Metabolic licenses the business system around that clinical core. Atlas provides no medical services and employs no clinicians. Clinical care is always delivered by a separately licensed medical entity that the partner establishes with their own counsel. That division is exactly why the five questions below are yours and not ours.

• Ownership: who may hold equity in the entity that renders care
• Management: whether a services agreement can carry the business functions, and how the fee is calculated
• Staffing: what Tennessee attaches to nurse practitioner practice
• Telehealth: whether a first encounter can happen on video
• Filings: which two agencies own your calendar

Question one: who may own the Tennessee medical entity?

Tennessee Attorney General Opinion No. 07-116, issued August 8, 2007, took up this question directly. Its stated opinion is that it is “not lawful for a certified nurse practitioner, registered nurse, advanced practice nurse, licensed practical nurse or physician assistant to own and operate a professional corporation or professional limited liability company (PLLC) for the provision of medical services,” with a narrow carve-out for a physician assistant holding shares alongside licensed physicians. An AG opinion is advisory, not binding law, and that one is nineteen years old. Ask your Tennessee healthcare counsel whether a lay-owned holding structure above a clinician-owned professional entity is consistent with how the state currently treats ownership of a medical entity, and confirm it with the Tennessee Board of Medical Examiners.

Then ask which license types may hold equity, and what happens to the entity if a clinician owner exits mid-year. Ask too what the entity is called in the filing: Tennessee professional corporations and professional limited liability companies are formed with the Tennessee Secretary of State, which is also where the annual report lands.

This is usually the moment a buyer discovers that a license and a franchise are different animals. Read the difference between a franchise and a license agreement before you brief anyone, because it changes the question you are actually asking your attorney to answer.

Question two: will a management structure hold up, and how is the fee calculated?

Where the professional entity must be clinician-owned, the business side is carried by a separate management company under a written services agreement. Whether that split holds in Tennessee is not something this page can tell you. Ask your Tennessee counsel whether such an agreement is consistent with how the state treats control over clinical judgment, and confirm it with the Tennessee Board of Medical Examiners. The recurring criticism nationally, documented in the Milbank Memorial Fund's April 2025 issue brief on management services organisations, is not the existence of the structure but the degree of control the management side exerts.

Have counsel look hardest at the fee methodology. A management fee calculated as a share of clinical revenue has the same compounding shape as a royalty even when the contract calls it something else, which is why it is worth understanding what a gross royalty really costs over the life of a business before you agree to any percentage arrangement anywhere in your stack.

Atlas takes no percentage of partner revenue and charges no ongoing partner fees. The license fee is one-time and identical in every state. The figure is not published; it is disclosed in full on the fit call. The license fee is one-time. It carries 0% of revenue and no ongoing partner fees. The figure is not published anywhere, by design — it is disclosed in full on the fit call, where it can be put next to what it covers instead of floating on its own.

Question three: who sees the member and signs the prescription?

Board of Medical Examiners rules on nurse practitioner supervision sit at Tenn. Comp. R. and Regs. 0880-06-.02. Subsection (9) reads: “The supervising physician shall be required to visit any remote site at least once every thirty (30) days.” Subsection (8) requires the physician to “personally review at least twenty percent (20%) of charts monitored or written by the certified nurse practitioner every thirty (30) days.” That chapter has been amended before and the terminology here has been moving, so confirm the current text with the Tennessee Board of Medical Examiners and the Tennessee Board of Nursing rather than relying on a marketing page.

Then ask counsel the question that actually shapes your build: what counts as a “remote site” when a program is delivered largely by screen. If a monthly physical visit is in scope, your collaborating physician is not a signature on a page. They are a recurring scheduled commitment with a travel line attached, and that shapes whether a Nashville build leans on a location or a screen. The comparison of the clinic model against the digital model is the right primer before you sign a lease in the Gulch.

Ask Atlas to put this in writing: whether the Atlas telehealth stack is pre-configured for Tennessee e-prescribing and collaborating-physician documentation, or whether the partner's medical entity supplies that layer

Question four: can care begin on a screen in Tennessee?

The board's telemedicine rule is Tenn. Comp. R. and Regs. 0880-02-.16. It states that “[a] physician-patient relationship exists when a physician serves a patient's medical needs whether or not there has been an encounter in person between the physician and patient.” The same rule states it “is not meant to alter or amend the applicable standard of care in any particular field of medicine.” Read those two sentences together, never either one alone.

Ask your Tennessee counsel whether a statewide, screen-first enrollment model run from a Nashville base is consistent with how the state treats the formation of that relationship, and confirm it with the board. Ask separately what federal controlled-substance rules add for any medication class the program intends to carry; the state rule does not answer that. The harder question underneath both — what the standard of care requires for a specific patient on a specific day — belongs to the separately licensed medical entity and its clinicians, not to Atlas and not to any marketing page.

Ask counsel too: what documentation must the medical entity keep to show a remote encounter met the standard, and does that answer change by medication class?

Question five: the Tennessee and Davidson County filing calendar

Licensing runs through the Tennessee Board of Medical Examiners, administered by the Tennessee Department of Health in Nashville, with nursing under the Tennessee Board of Nursing. Entity formation and annual reports run through the Tennessee Secretary of State. Two agencies, two calendars, and they do not coordinate for you.

Tennessee also imposes franchise and excise taxes on entities doing business in the state, administered by the Tennessee Department of Revenue. Ask your accountant whether your entity owes those, whether Tennessee business tax reaches your receipts, and what the Davidson County side of a Nashville business license requires. Confirm current rates, thresholds and dates with the Department of Revenue. Professional entities are not treated identically to a plain LLC and the numbers move.

Put both calendars on the build timeline before you commit to a launch date. A build that is ready to sell three weeks before the entity is ready to treat is not a fast build.

What Atlas builds in Nashville, and what it deliberately does not

Atlas licenses the operating system: the telehealth stack, the ordering system, member AI coaching, the brand kit and the operational playbooks, delivered as one build. Atlas does not form your entity, does not select or supervise clinicians, and does not offer a view on Tennessee law. Those belong to you and your counsel, permanently.

What Atlas withholds matters as much. There is no revenue share, no ongoing fee and no assigned exclusive geography. Franchises sell territory; Atlas does not, and the reasoning is set out in the piece on what independent ownership actually means for a clinic. A market is where you choose to operate, not something Atlas grants or fences.

— fill only with a named, consented Atlas partner operating in this market, quoted verbatim with written permission. No composites, no stock imagery, no unattributed quotes.

When you are ready to test fit, bring your counsel's answers to the five questions above to the apply page and start the fit call. The conversation is shorter and considerably more honest when you already know what Tennessee requires of you.

What this page is not

This page is general commentary published by a company. Atlas Metabolic is not a law firm and offers no view on what Tennessee law requires of you. Nothing here is legal advice, and nothing here creates an attorney-client relationship.

Regulation in this area changes and varies with the exact structure you build. A rule quoted accurately today can be amended, reinterpreted by a board, or simply not apply to your arrangement. Confirm every rule quoted above against the current text held by the Tennessee Board of Medical Examiners, the Tennessee Board of Nursing or the Tennessee Secretary of State.

Every question raised above belongs to your own healthcare counsel, licensed in Tennessee, reviewing your facts. Where this page states a rule it quotes a named source and links it; where it has no named source it asks a question instead, and that is deliberate.

Atlas Metabolic provides no medical services and employs no clinicians. Clinical care is delivered by a separately licensed medical entity that the partner establishes with their own counsel.

FREQUENTLY ASKED QUESTIONS.