Organization Active NPI

Livefreely Inc

  • Public Health or Welfare Agency
  • San Jose, CA
National Provider Identifier
1023689973
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
LIVEFREELY INC
Practice address
4820 Harwood Rd Ste 200
San Jose, CA 95124-5273
Phone
(408) 981-5577
NPI assigned
Jul 1, 2021
Last updated
Jul 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel Jue
Title
Co-Owner
Phone
(408) 981-5577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

4820 Harwood Rd Ste 200
San Jose, CA 95124-5273

Mailing address

167 Bangor Ave
San Jose, CA 95123-3602
Phone (408) 981-5577

Other identifiers 1

IdentifierTypeStateIssuer
A4757579OtherCADRIVERS LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@livefreely.today Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210702001861 CA Part B Supplier - Mass Immunization (Roster Biller Only) 8224439807 Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

4820 Harwood Rd
Ste 200
San Jose, CA 95124
Phone (408) 981-5577

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1023689973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 BANGOR AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233602",
            "telephone_number": "408-981-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 HARWOOD RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951245273",
            "telephone_number": "408-981-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVEFREELY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "JUE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "408-981-5577"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "A4757579",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@livefreely.today",
            "affiliation": "N",
            "endpointDescription": "Direct organization email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "text",
            "address_1": "4820 Harwood Rd Ste 200",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951245273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.