Active NPI
First Lady Wellness LLC
- Nurse Practitioner
- Portland, OR
National Provider Identifier
1255160420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- FIRST LADY WELLNESS LLC
- Practice address
- 314 NE 19TH Ave
Portland, OR 97232-2829 - Phone
- (415) 999-2792
- NPI assigned
- Jul 29, 2024
- Last updated
- Jul 29, 2024
- 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
- Elizabeth A Holmes, AGNP-BC
- Title
- Nurse Practitioner
- Phone
- (503) 447-6886
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | NU | ||
| Registered Nurse | 163W00000X | NU | ||
| Nurse Practitioner | 363L00000X | NU | Primary |
Addresses
Primary practice location
314 NE 19TH Ave
Portland, OR 97232-2829
Mailing address
2623 9TH Ave
Oakland, CA 94606-2127
Phone (415) 999-2792
National Provider Directory
National Provider DirectoryLocations
314 NE 19th Ave
Portland, OR 97232
Phone (503) 239-8181
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Registered Nurse
- Oakland, CA
- NPI 1467332957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722211200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722211200000",
"number": "1255160420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2623 9TH AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946062127",
"telephone_number": "415-999-2792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 NE 19TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322829",
"telephone_number": "415-999-2792"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FIRST LADY WELLNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-07-29",
"last_updated": "2024-07-29",
"certification_date": "2024-07-27",
"status": "A",
"authorized_official_last_name": "HOLMES",
"authorized_official_first_name": "ELIZABETH",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "NURSE PRACTITIONER",
"authorized_official_telephone_number": "503-447-6886",
"authorized_official_credential": "AGNP-BC"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.