Ingredients for Life LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INGREDIENTS FOR LIFE LLC

Practice address

7490 Clubhouse Rd Ste 105
Boulder, CO 80301-3720

Phone

(720) 582-1212

Fax

(720) 405-4268

NPI assigned

Jan 30, 2023

Organization subpart

No

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

Authorized official

Name

Kristina Anton-Schnell, MDNPI 1477577153

Title

Owner

Phone

(720) 582-1212

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristina A Anton-Schnell, MD

  • Internal Medicine Physician
  • Boulder, CO
  • NPI 1477577153

  Internal Medicine

  NPD Authorized official

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1619683000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 JAMESTON ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803014222",
            "telephone_number": "720-582-1212",
            "fax_number": "720-405-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7490 CLUBHOUSE RD STE 105",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013720",
            "telephone_number": "720-582-1212",
            "fax_number": "720-405-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGREDIENTS FOR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "ANTON-SCHNELL",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-582-1212",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Boulder, CO
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.