Life Raft Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LIFE RAFT PSYCHIATRY LLC

Practice address

311 E Pleasant Valley Blvd
Altoona, PA 16602-5512

Phone

(814) 243-5365

NPI assigned

Sep 18, 2024

Last updated

Sep 18, 2024By 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

Margaret ShafferNPI 1770874125

Title

Owner

Phone

(814) 243-5365

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 2

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.

• Margaret Kay Shaffer, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Benedict, PA
  • NPI 1770874125

  Family

  Medicare reassignment NPD Authorized official
• Fawn Lynn Baldauf, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Altoona, PA
  • NPI 1114256138

  Family

  Medicare reassignment NPD

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1124855606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E PLEASANT VALLEY BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166025512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E PLEASANT VALLEY BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166025512",
            "telephone_number": "814-243-5365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "276 Jackman Rd",
            "address_purpose": "LOCATION",
            "city": "St Benedict",
            "state": "PA",
            "postal_code": "157737724",
            "country_code": "US",
            "telephone_number": "814-243-5365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE RAFT PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-243-5365"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Altoona, PA
• Providers in Altoona, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.