Active NPI
Rise Wellness and Longevity, LLC
- Health & Wellness Coach
- Prineville, OR
National Provider Identifier
1427968668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- Legal business name
- RISE WELLNESS AND LONGEVITY, LLC
- Practice address
- 427A N Main St
Prineville, OR 97754-1855 - Phone
- (541) 903-2758
- NPI assigned
- Sep 10, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeremy Hicks, ISSA NUTRITION COACH
- Title
- Owner/Health Coach
- Phone
- (541) 903-2758
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | Primary |
Addresses
Primary practice location
427A N Main St
Prineville, OR 97754-1855
Mailing address
427A N Main St
Prineville, OR 97754-1855
Phone (541) 903-2758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788998400000",
"number": "1427968668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "427A N MAIN ST",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977541855",
"telephone_number": "541-903-2758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427A N MAIN ST",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977541855",
"telephone_number": "541-903-2758"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RISE WELLNESS AND LONGEVITY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-10",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A",
"authorized_official_last_name": "HICKS",
"authorized_official_first_name": "JEREMY",
"authorized_official_title_or_position": "OWNER/HEALTH COACH",
"authorized_official_telephone_number": "541-903-2758",
"authorized_official_credential": "ISSA NUTRITION COACH"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prineville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.