NPIMap

Organization Active NPI

Healthy Living Primary Care, Inc

  • Family Medicine Physician
  • Folsom, CA
National Provider Identifier
1144414293
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A9350 Issued in CA
Legal business name
HEALTHY LIVING PRIMARY CARE, INC
Practice address
82 Clarksville Rd Ste 120
Folsom, CA 95630-8210
Phone
(916) 983-8868
Fax
(916) 983-8891
NPI assigned
Aug 31, 2007
Last updated
Jan 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Authorized official

Name
Dr. Joy Liu, D.O.NPI 1912128547
Title
President
Phone
(916) 983-8868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 20A9350 CA Primary

Addresses

Primary practice location

82 Clarksville Rd Ste 120
Folsom, CA 95630-8210

Mailing address

2545 E Bidwell St
110
Folsom, CA 95630-6440
Phone (916) 983-9886

Other practice location 1

11634 Fair Oaks Blvd
Fair Oaks, CA 95628-3771
Phone (916) 983-8868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070927000419 CA Part B Supplier - Clinic/Group Practice 7618062225 Receives reassigned benefits from 23 practitioners
Practice locations: El Dorado Hills, CA; Fair Oaks, CA; Folsom, CA; Granite Bay, CA; Rancho Cordova, CA; Sacramento, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1070168Healthy Living Primary Care82 Clarksville Rd Ste 120, Folsom, CA 95630Certificate of waiverJun 20, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1144414293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 E BIDWELL ST",
            "address_2": "110",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306440",
            "telephone_number": "916-983-9886",
            "fax_number": "916-983-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 CLARKSVILLE RD STE 120",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308210",
            "telephone_number": "916-983-8868",
            "fax_number": "916-983-8891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11634 Fair Oaks Blvd",
            "address_purpose": "LOCATION",
            "city": "Fair Oaks",
            "state": "CA",
            "postal_code": "956283771",
            "country_code": "US",
            "telephone_number": "916-983-8868",
            "fax_number": "916-983-8891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTHY LIVING PRIMARY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-31",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-983-8868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.