A Breath for Life LLC

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

Legal business name

A BREATH FOR LIFE LLC

Practice address

5626 N 51St Ave
Glendale, AZ 85301-6034

Phone

(623) 930-0887

NPI assigned

May 30, 2019

Organization subpart

No

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

Authorized official

Name

Annette Ryder

Title

Owner

Phone

(602) 615-4636

Specialties & licenses 1

Addresses

Other names 1

• Serenity A Breath for Life Doing business as

Locations

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578873600000",
    "number": "1407414063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853550217",
            "telephone_number": "602-615-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5626 N 51ST AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853016034",
            "telephone_number": "623-930-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BREATH FOR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-30",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A",
        "authorized_official_last_name": "RYDER",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-615-4636"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity A Breath for Life",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Serenity A Breath for Life",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.