NPIMap

Organization Active NPI

Independent Lifestyles, Inc.

  • Case Management Agency
  • Sauk Rapids, MN
National Provider Identifier
1144852732
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
INDEPENDENT LIFESTYLES, INC.
Practice address
215 N Benton Dr
Sauk Rapids, MN 56379-1530
Phone
(320) 529-9000
Fax
(320) 529-0747
NPI assigned
Feb 11, 2020
Last updated
Dec 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Authorized official

Name
Jennifer A Hermanson
Title
Administrative Director
Phone
(320) 281-2027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

215 N Benton Dr
Sauk Rapids, MN 56379-1530

Mailing address

215 N Benton Dr
Sauk Rapids, MN 56379-1530

Other identifiers 4

IdentifierTypeStateIssuer
A558653000OtherMNMN DEPT. OF HUMAN SERVICES (DHS) UMPI # FOR PCA CHOICE
A114035300OtherMNMN DEPT. OF HUMAN SERVICES (DHS) UMPI # FOR WAIVER SERVICES
1068099OtherMNMN DEPT. OF HUMAN SERVICES (DHS)- 245D LICENSE
A768487000OtherMNMN DEPT. OF HUMAN SERVICES (DHS) UMPI # FOR CASE MGMT.

National Provider Directory

National Provider Directory

Locations

215 N Benton Dr
Sauk Rapids, MN 56379
Phone (320) 281-2030

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1144852732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N BENTON DR",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N BENTON DR",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791530",
            "telephone_number": "320-529-9000",
            "fax_number": "320-529-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT LIFESTYLES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A",
        "authorized_official_last_name": "HERMANSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "320-281-2027"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN DEPT. OF HUMAN SERVICES (DHS) UMPI # FOR PCA CHOICE",
            "identifier": "A558653000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN DEPT. OF HUMAN SERVICES (DHS) UMPI # FOR WAIVER SERVICES",
            "identifier": "A114035300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN DEPT. OF HUMAN SERVICES (DHS)- 245D LICENSE",
            "identifier": "1068099",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN DEPT. OF HUMAN SERVICES (DHS) UMPI # FOR CASE MGMT.",
            "identifier": "A768487000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sauk Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.