Organization Active NPI

Healthy Life Corporation

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1356723837
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP7820 Issued in AZ
Legal business name
HEALTHY LIFE CORPORATION
Practice address
10240 W Indian School Rd Ste 155
Phoenix, AZ 85037-5909
Phone
(623) 385-7900
Fax
(623) 792-1233
NPI assigned
Jun 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Authorized official

Name
Ms. Martha Ann Conradson
Title
Administrator
Phone
(623) 385-7900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP7820 AZ Primary

Addresses

Primary practice location

10240 W Indian School Rd Ste 155
Phoenix, AZ 85037-5909

Mailing address

10240 W Indian School Rd Ste 155
Phoenix, AZ 85037-5909
Phone (623) 385-7900

Other names 1

  • Desert Bloom Family Medicine Other name

National Provider Directory

National Provider Directory

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": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1356723837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10240 W INDIAN SCHOOL RD STE 155",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375909",
            "telephone_number": "623-385-7900",
            "fax_number": "623-792-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10240 W INDIAN SCHOOL RD STE 155",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375909",
            "telephone_number": "623-385-7900",
            "fax_number": "623-792-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIFE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "CONRADSON",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "623-385-7900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP7820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Bloom Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.