Trinity Health & Wellness Family Practice PLLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

AP9834 Issued in AZ

Legal business name

TRINITY HEALTH & WELLNESS FAMILY PRACTICE PLLC

Practice address

45 Capri Blvd Ste F
Lake Havasu City, AZ 86403-5657

Phone

(928) 234-1177

Fax

(928) 733-6259

NPI assigned

Oct 21, 2017

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chris Ann Dipaola, FNP

Title

Family Nurse Practitioner

Phone

(603) 731-5907

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1508544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1295246932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3869 CHESAPEAKE PL",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864064343",
            "telephone_number": "603-731-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CAPRI BLVD STE F",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035657",
            "telephone_number": "928-234-1177",
            "fax_number": "928-733-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HEALTH & WELLNESS FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-21",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "DIPAOLA",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "603-731-5907",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AZ",
            "license": "AP9834",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "AP9834",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669836748",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Randal L. Troyer, M.D.
• True Rehab of Arizona,LLC

• Health Service Clinic/Center in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Health Service Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.