Lifestyle Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2000216 Issued in NM

Legal business name

LIFESTYLE MEDICINE LLC

Practice address

1301 8TH St
Las Vegas, NM 87701-4221

Phone

(505) 425-2850

Fax

(505) 425-2847

NPI assigned

Oct 16, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Nancy Kanode

Title

Officer

Phone

(505) 425-2850

Specialties & licenses 1

Addresses

Other names 1

• Bradley Kanode MD Doing business as

Locations

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1245429216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 8TH ST",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014221",
            "telephone_number": "505-425-2850",
            "fax_number": "505-425-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 8TH ST",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014221",
            "telephone_number": "505-425-2850",
            "fax_number": "505-425-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "KANODE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "505-425-2850",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "2000216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bradley Kanode MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• George Leone, PH.D.
• Bethany Lesse
• Dena Lewis, DNP, APRN, AGACNP-BC
• Jennifer Anthea Liatas-Underhill, LMHC
• Terra H. Liddil, RPH, PHARMD
• Lincare Inc
• William R Linzie, M.S.CCC-SLP
• Lyndon Ofa Liti
• Mark D Livingston, BA
• Suzanne Llamas, P.T.

• Internal Medicine Physician in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.