NPIMap

Organization Active NPI

Live Bold

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1699210708
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209009533 Issued in IL
Legal business name
LIVE BOLD
Practice address
33 W Delaware PL
Chicago, IL 60610-8115
Phone
(978) 877-0781
NPI assigned
Dec 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Authorized official

Name
Allison Blood
Title
Owner
Phone
(978) 877-0781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 209009533 IL Primary

Addresses

Primary practice location

33 W Delaware PL
Chicago, IL 60610-8115

Mailing address

33 W Delaware Place
Chicago, IL 60610

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1699210708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W DELAWARE PLACE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W DELAWARE PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606108115",
            "telephone_number": "978-877-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE BOLD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-28",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "BLOOD",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-877-0781"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.