Impact Lifeline

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

IMPACT LIFELINE

Practice address

205 W 11TH St
Rolla, MO 65401-2804

Phone

(314) 279-4565

Fax

(309) 326-4526

NPI assigned

Feb 14, 2025

Organization subpart

No

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

Authorized official

Name

Alisha Michelle Jones, NP-CNPI 1306453014

Title

Executive Administrator

Phone

(314) 279-4565

Specialties & licenses 5

Addresses

Practitioners 1

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

• Alisha Michelle Jones, FNP-C

  • Family Nurse Practitioner
  • Rolla, MO
  • NPI 1306453014
  NPD Authorized official

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1467257576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LAURELWOOD CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464940",
            "telephone_number": "314-279-4565",
            "fax_number": "309-326-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W 11TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012804",
            "telephone_number": "314-279-4565",
            "fax_number": "309-326-4526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13191 Rich Ln",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654017546",
            "country_code": "US",
            "telephone_number": "314-279-4565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IMPACT LIFELINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "314-279-4565",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Ashley Hunsberger
• Matthew Warren Hurley, M.D.
• Yasemin Dawn Hurley, O.D.
• Randall D. Huss, MD
• Gregory B Hussey, LPC, MA
• Invision Family Eye Care
• Fauzia Iqbal, MD
• Jesse D Irwin, ATC
• Isd Renal Inc
• Alfaye Jackson, PLPC

• Rural Health Clinic/Center in Rolla, MO
• Providers in Rolla, MO by specialty
• Rural Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.