Lifestyle Wellness Center

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

LIFESTYLE WELLNESS CENTER

Practice address

3333 E Shelby Dr
Suite 3
Memphis, TN 38118-7256

Phone

(901) 794-3707

Fax

(901) 794-3690

NPI assigned

Jun 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Ivory Lee Taylor, ED.D

Title

Ceo

Phone

(901) 794-3707

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434672000000",
    "number": "1194107706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E SHELBY DR",
            "address_2": "SUITE 3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381187256",
            "telephone_number": "901-794-3707",
            "fax_number": "901-794-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E SHELBY DR",
            "address_2": "SUITE 3",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381187256",
            "telephone_number": "901-794-3707",
            "fax_number": "901-794-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "IVORY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-794-3707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCERETARY OF STATE CONTROL NUMBER",
            "identifier": "000793975",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Memphis, TN
• Providers in Memphis, TN by specialty
• Health Service Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.