Iannotti Lifestyle Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0039567 Issued in CO

Legal business name

IANNOTTI LIFESTYLE CLINIC PC

Practice address

150 Old Laramie TRL E
Suite 210
Lafayette, CO 80026-7018

Phone

(720) 773-1352

Fax

(303) 604-6958

NPI assigned

May 3, 2016

Organization subpart

No

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

Authorized official

Name

Michael Robert Iannotti, MD

Title

Physician/ Owner

Phone

(720) 773-1352

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1396190831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 OLD LARAMIE TRL E",
            "address_2": "SUITE 210",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267018",
            "telephone_number": "720-773-1352",
            "fax_number": "303-604-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 OLD LARAMIE TRL E",
            "address_2": "SUITE 210",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267018",
            "telephone_number": "720-773-1352",
            "fax_number": "303-604-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IANNOTTI LIFESTYLE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "IANNOTTI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN/ OWNER",
        "authorized_official_telephone_number": "720-773-1352",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0039567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.