NPIMap

Organization Active NPI

Lifestream Clinic

  • Chiropractor
  • Grimes, IA
National Provider Identifier
1124475033
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
080433 Issued in IA
Legal business name
LIFESTREAM CLINIC
Practice address
1830 SE Princeton Dr
Suite D
Grimes, IA 50111-4826
Phone
(515) 259-9336
NPI assigned
May 20, 2016
Last updated
May 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Authorized official

Name
Dr. Amanda Carver
Title
Chiropractor
Phone
(515) 259-9336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 080433 IA Primary

Addresses

Primary practice location

1830 SE Princeton Dr
Suite D
Grimes, IA 50111-4826

Mailing address

1830 SE Princeton Dr
Suite D
Grimes, IA 50111-4826

National Provider Directory

National Provider Directory
Tax ID family
Lifestream Chiropractic Clinic2 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": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1124475033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 SE PRINCETON DR",
            "address_2": "SUITE D",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501114826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 SE PRINCETON DR",
            "address_2": "SUITE D",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501114826",
            "telephone_number": "515-259-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTREAM CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "CARVER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "515-259-9336",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "080433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grimes, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.