Well Life LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

WELL LIFE LLC

Practice address

1700 W Whitton Ave
Phoenix, AZ 85015-5533

Phone

(602) 318-4383

NPI assigned

Dec 29, 2022

Organization subpart

No

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

Authorized official

Name

Anthony Populo

Title

Founder

Phone

(602) 318-4383

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1356054860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W WHITTON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155533",
            "telephone_number": "602-318-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W WHITTON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155533",
            "telephone_number": "602-318-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-29",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "POPULO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "602-318-4383"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.