Healthy Life PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21264 Issued in OK

Legal business name

HEALTHY LIFE PLLC

Practice address

800 W Boise Cir
Suite 290
Broken Arrow, OK 74012-4906

Phone

(918) 344-9368

NPI assigned

Nov 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Roberta Rau, M.D.

Title

President/Owner

Phone

(918) 344-9368

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1700120458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W BOISE CIR",
            "address_2": "SUITE 290",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124906",
            "telephone_number": "918-344-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W BOISE CIR",
            "address_2": "SUITE 290",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124906",
            "telephone_number": "918-344-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIFE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "RAU",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "918-344-9368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "21264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.