One Life Inc.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN 16715 Issued in MT

Legal business name

ONE LIFE INC.

Practice address

186 S. Third Street
Hamilton, MT 59066

Phone

(406) 360-2101

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Alexis D Wagner

Title

President

Phone

(406) 360-2101

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598843922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BEAN CREEK RD. #12",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "95066",
            "telephone_number": "406-360-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 S. THIRD STREET",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "59066",
            "telephone_number": "406-360-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE LIFE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-360-2101"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "RN 16715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43000813",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9982706",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Hamilton, MT
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.