Quality Life Medical Practice LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

QUALITY LIFE MEDICAL PRACTICE LLC

Doing business as

Quality Life Family Practice, LLC

Practice address

1201 NE 7TH St Ste E
Grants Pass, OR 97526-1451

Phone

(541) 314-4894

Fax

(541) 314-4895

NPI assigned

Dec 2, 2020

Last updated

Apr 20, 2021By 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

Darlena Pike, NURSE PRACTITIONERNPI 1255614160

Title

FNP/Co-Owner

Phone

(541) 314-4894

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Quality Life Family Practice, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Darlena Rose Pike, FNP

  • Family Nurse Practitioner
  • Grants Pass, OR
  • NPI 1255614160
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1689279184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 NE 7TH ST STE E",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261451",
            "telephone_number": "541-314-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NE 7TH ST STE E",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261451",
            "telephone_number": "541-314-4894",
            "fax_number": "541-314-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY LIFE MEDICAL PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "PIKE",
        "authorized_official_first_name": "DARLENA",
        "authorized_official_title_or_position": "FNP/CO-OWNER",
        "authorized_official_telephone_number": "541-314-4894",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500642365",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quality Life Family Practice, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quality Life Family Practice, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Russ Pulliam
• Lance Christopher Pursley, LAC, MAOM
• Regina Purtzer
• Merri Sjaan Pylkas, PT
• Todd M Pylkas, PT
• Richard Anthony(Tony) Quicke
• Kim Ann Quigley
• Heather Quinn
• Amorette Quintanilla, B.A.
• Michael A. Radcliffe, LCSW

• Primary Care Clinic/Center in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.