Transformative Healthcare LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036121823 Issued in IL

Legal business name

TRANSFORMATIVE HEALTHCARE LLC

Practice address

4 Country Club Executive Park
Glen Carbon, IL 62034-1702

Phone

(618) 659-5567

NPI assigned

Jan 23, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Alisha Allen White, MDNPI 1467600155

Title

Physician/Owner

Phone

(618) 659-5567

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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

• Alisha Allen White, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1467600155
  NPD Authorized official
• Barry F Zeffren, MD

  • Allergy & Immunology Physician
  • Saint Louis, MO
  • NPI 1205908639
  NPD (past)

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1356849566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COUNTRY CLUB EXECUTIVE PARK",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COUNTRY CLUB EXECUTIVE PARK",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341702",
            "telephone_number": "618-659-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATIVE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "618-659-5567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036121823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1467600155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Threlkeld, DPT
• Todd Wollbrinck, OD, PC
• Heidi Marie Trackwell, PHARM.D.
• Patricia J Tracy, M.S., CCC-SLP
• Transformations, LLC
• Cheri Trauernicht, RPH
• Avarie Trent
• Aylah Shadora Trice
• Jessica Ulrich
• Andrew C Unfried, D.C.

• Internal Medicine Physician in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Internal Medicine Physician in Illinois

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