US Live Clinic LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

US LIVE CLINIC LLC

Practice address

12610 E Laurel LN
Scottsdale, AZ 85259-3460

Phone

(480) 707-1597

NPI assigned

Jun 11, 2020

Last updated

Jun 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin Vafai

Title

Owner

Phone

(480) 707-1597

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1043835424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12610 E LAUREL LN",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593460",
            "telephone_number": "480-707-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12610 E LAUREL LN",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593460",
            "telephone_number": "480-707-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US LIVE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "VAFAI",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-707-1597"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.