Blue Lotus Life LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

BLUE LOTUS LIFE LLC

Practice address

3808 N 60TH St
Milwaukee, WI 53216-2133

Phone

(414) 999-1117

NPI assigned

Apr 5, 2023

Last updated

Apr 5, 2023By 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

Miss Shantell Riley, REGISTERED NURSENPI 1649971235

Title

Owner

Phone

(414) 522-5924

Specialties & licenses 1

Addresses

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.

• Shantell Riley, RN

  • Registered Nurse
  • Milwaukee, WI
  • NPI 1649971235
  NPD Authorized official

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1609561752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 N 60TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162133",
            "telephone_number": "414-522-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 N 60TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162133",
            "telephone_number": "414-999-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE LOTUS LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "SHANTELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-522-5924",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Case Management Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.