NPIMap

Organization Active NPI

Lifeclinic Chiropractic of Nevada LLC

  • Chiropractor
  • Henderson, NV
National Provider Identifier
1083955546
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03221 Issued in MN
Legal business name
LIFECLINIC CHIROPRACTIC OF NEVADA LLC
Practice address
121 Carnegie St
Henderson, NV 89074-7118
Phone
(952) 229-7558
NPI assigned
Mar 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Authorized official

Name
Reza Alizadeh, D.C.
Title
Owner
Phone
(651) 690-0866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 03221 MN Primary

Addresses

Primary practice location

121 Carnegie St
Henderson, NV 89074-7118

Mailing address

PO Box 549
Chanhassen, MN 55317-0549
Phone (952) 229-7558

National Provider Directory

National Provider Directory
Tax ID family
Lifeclinic Chiropractic of Nevada LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1083955546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553170549",
            "telephone_number": "952-229-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CARNEGIE ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747118",
            "telephone_number": "952-229-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECLINIC CHIROPRACTIC OF NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-08",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "ALIZADEH",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-690-0866",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "03221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.