Organization Active NPI

Empower Lifestyle Medicine PLLC

  • Adult Medicine Physician
  • Gainesville, FL
National Provider Identifier
1578309902
Registry record updated Jul 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
EMPOWER LIFESTYLE MEDICINE PLLC
Practice address
5208 SW 91St Dr Ste E
Gainesville, FL 32608-9117
Phone
(352) 200-2465
NPI assigned
Jul 4, 2024
Last updated
Jul 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2024

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

Authorized official

Name
Volha IhnatsenkaNPI 1316027782
Title
MD
Phone
(352) 682-5306

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X Primary
Gynecology Physician 207VG0400X
Pediatrics Physician 208000000X
Obesity Medicine (Preventive Medicine) Physician 2083B0002X

Addresses

Primary practice location

5208 SW 91St Dr Ste E
Gainesville, FL 32608-9117

Mailing address

9200 NW 39TH Ave Ste 130
PO Box 3239
Gainesville, FL 32606-7366
Phone (352) 682-5640

National Provider Directory

National Provider Directory

Locations

5208 SW 91st Dr
Ste E
Gainesville, FL 32608
Phone (352) 200-2465

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1720051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720051200000",
    "number": "1578309902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 NW 39TH AVE STE 130",
            "address_2": "PO BOX 3239",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067366",
            "telephone_number": "352-682-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 SW 91ST DR STE E",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089117",
            "telephone_number": "352-200-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWER LIFESTYLE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-04",
        "last_updated": "2024-07-04",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "IHNATSENKA",
        "authorized_official_first_name": "VOLHA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "352-682-5306"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; 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.