Annual Wellness Centers LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

ANNUAL WELLNESS CENTERS LLC

Practice address

116 Lake Havasu Ave S Ste 103
Lake Havasu City, AZ 86403-0811

Phone

(928) 733-3311

NPI assigned

Feb 6, 2015

Last updated

Feb 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard Byrd

Title

Owner

Phone

(928) 412-5005

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1609267038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 LAKE HAVASU AVE S STE 103",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864030811",
            "telephone_number": "928-733-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 LAKE HAVASU AVE S STE 103",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864030811",
            "telephone_number": "928-733-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNUAL WELLNESS CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-412-5005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Adult Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.