Institute for Dynamic Living Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

10024995A Issued in IN

Legal business name

INSTITUTE FOR DYNAMIC LIVING INC

Doing business as

Better Life Wellness Center

Practice address

1528 NW 5TH St
Suite 100
Richmond, IN 47374-1844

Phone

(765) 935-0070

Fax

(765) 935-0073

NPI assigned

Nov 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Steven Edward Stoller, M.D.

Title

Ceo

Phone

(765) 935-0070

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Better Life Wellness Center Doing business as

Locations

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1437331618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 NW 5TH ST",
            "address_2": "SUITE 100",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741844",
            "telephone_number": "765-935-0070",
            "fax_number": "765-935-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 NW 5TH ST",
            "address_2": "SUITE 100",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741844",
            "telephone_number": "765-935-0070",
            "fax_number": "765-935-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE FOR DYNAMIC LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "STOLLER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-935-0070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "10024995A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201293710A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Better Life Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Richmond, IN
• Providers in Richmond, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.