NPIMap

Organization Active NPI

Livewell Family Clinic LLC

  • Family Nurse Practitioner
  • Temple Hills, MD
National Provider Identifier
1649760075
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LIVEWELL FAMILY CLINIC LLC
Practice address
3611 Branch Ave Ste 404
Temple Hills, MD 20748
Phone
(240) 719-2587
Fax
(240) 830-2320
NPI assigned
May 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Authorized official

Name
Betty E Arkhurst, NPNPI 1063969111
Title
Secretary
Phone
(301) 613-0529

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X R190895 MD
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3611 Branch Ave Ste 404
Temple Hills, MD 20748

Mailing address

3611 Branch Ave Ste 4043611
Temple Hills, MD 20748-1242
Phone (240) 719-2587

National Provider Directory

National Provider Directory

Locations

3611 Branch Ave
Ste 404
Temple Hills, MD 20748
Phone (240) 719-2587

3611 Branch Ave
Ste 4043611
Temple Hills, MD 20748

Practitioners & affiliated clinicians

Practitioners 2

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": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1649760075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 BRANCH AVE STE 4043611",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207481242",
            "telephone_number": "240-719-2587",
            "fax_number": "240-830-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 BRANCH AVE STE 404",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "20748",
            "telephone_number": "240-719-2587",
            "fax_number": "240-830-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVEWELL FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "ARKHURST",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "301-613-0529",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "R190895",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Hills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.