Active NPI
Living Well Health Care, LLC
- Psychiatric/Mental Health Nurse Practitioner
- Denver, CO
National Provider Identifier
1134512833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- NP990096
- Legal business name
- LIVING WELL HEALTH CARE, LLC
- Practice address
- 90 Madison St
Suite 305
Denver, CO 80206-5418 - Phone
- (303) 481-3451
- Fax
- (720) 889-9496
- NPI assigned
- Mar 5, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kristiana Avery, NP
- Title
- Owner, Nurse Practitioner
- Phone
- (303) 481-3451
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NP990096 | CO | Primary |
Addresses
Primary practice location
90 Madison St
Suite 305
Denver, CO 80206-5418
Mailing address
860 E 68TH Ave
Denver, CO 80229-7102
Phone (303) 481-3451
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23838736 | Medicaid | CO |
National Provider Directory
National Provider Directory- Tax ID family
- Living Well Health Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Mental Health Clinic/Center
- Denver, CO
- NPI 1508303132
Locations
860 E 68th Ave
Denver, CO 80229
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425513600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1425513600000",
"number": "1134512833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 E 68TH AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802297102",
"telephone_number": "303-481-3451",
"fax_number": "720-889-9496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 MADISON ST",
"address_2": "SUITE 305",
"city": "DENVER",
"state": "CO",
"postal_code": "802065418",
"telephone_number": "303-481-3451",
"fax_number": "720-889-9496"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIVING WELL HEALTH CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-03-05",
"last_updated": "2015-03-05",
"status": "A",
"authorized_official_last_name": "AVERY",
"authorized_official_first_name": "KRISTIANA",
"authorized_official_title_or_position": "OWNER, NURSE PRACTITIONER",
"authorized_official_telephone_number": "303-481-3451",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CO",
"license": "NP990096",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "23838736",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.