Organization Active NPI

Livewell Healthcare

  • Physician Assistant
  • Tahlequah, OK
National Provider Identifier
1558258285
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
LIVEWELL HEALTHCARE
Practice address
205 Harris Cir Ste 102
Tahlequah, OK 74464-8849
Phone
(719) 214-0270
NPI assigned
Jun 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Authorized official

Name
Jason Morgan, PANPI 1831176924
Title
Ceo
Phone
(719) 214-0270

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
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

205 Harris Cir Ste 102
Tahlequah, OK 74464-8849

Mailing address

PO Box 688
Stilwell, OK 74960-0688
Phone (719) 214-0270

Other identifiers 1

IdentifierTypeStateIssuer
1831176924OtherOKNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250723000308 OK Part B Supplier - Clinic/Group Practice 9931615358 Receives reassigned benefits from 1 practitioner
Practice locations: Tahlequah, OK

National Provider Directory

National Provider Directory

Locations

205 Harris Cir
Ste 102
Tahlequah, OK 74464
Phone (719) 214-0270

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": "1750723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752192000000",
    "number": "1558258285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 688",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749600688",
            "telephone_number": "719-214-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HARRIS CIR STE 102",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744648849",
            "telephone_number": "719-214-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVEWELL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "719-214-0270",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831176924",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.