NPIMap

Organization Active NPI

Io Wellness

  • Family Nurse Practitioner
  • Coos Bay, OR
National Provider Identifier
1497464671
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
IO WELLNESS
Practice address
89166 Lighthouse Way
Coos Bay, OR 97420-7649
Phone
(541) 245-7200
NPI assigned
Nov 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Authorized official

Name
Heather SullivanNPI 1205383890
Title
Owner
Phone
(541) 246-7200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

89166 Lighthouse Way
Coos Bay, OR 97420-7649

Mailing address

89166 Lighthouse Way
Coos Bay, OR 97420-7649
Phone (541) 245-7200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1497464671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89166 LIGHTHOUSE WAY",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974207649",
            "telephone_number": "541-245-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89166 LIGHTHOUSE WAY",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974207649",
            "telephone_number": "541-245-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IO WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-246-7200"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.