Organization Active NPI

Infinity Lifestyle Medicine

  • Medical Specialty Clinic/Center
  • Erie, PA
National Provider Identifier
1356163752
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
INFINITY LIFESTYLE MEDICINE
Practice address
2115 W 38TH St
Erie, PA 16508-1925
Phone
(814) 304-8560
Fax
(814) 352-9022
NPI assigned
Oct 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Justin Scholl, PHARMD
Title
Chief Operating Officer
Phone
(814) 304-8560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

2115 W 38TH St
Erie, PA 16508-1925

Mailing address

2115 W 38TH St
Erie, PA 16508-1925
Phone (814) 304-8560

National Provider Directory

National Provider Directory

Locations

2115 W 38th St
Erie, PA 16508
Phone (814) 722-6062

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1356163752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081925",
            "telephone_number": "814-304-8560",
            "fax_number": "814-352-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081925",
            "telephone_number": "814-304-8560",
            "fax_number": "814-352-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITY LIFESTYLE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "SCHOLL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "814-304-8560",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.