NPIMap

Organization Active NPI

Lifeworks Integrative Health LLC

  • Physical Medicine & Rehabilitation Physician
  • Shawnee, KS
National Provider Identifier
1710257928
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
LIFEWORKS INTEGRATIVE HEALTH LLC
Practice address
22742 Midland Dr
Shawnee, KS 66226-3553
Phone
(913) 441-2293
NPI assigned
Jan 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Authorized official

Name
Matthew Gianforte, DCNPI 1932103751
Title
Owner
Phone
(913) 441-2293

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

22742 Midland Dr
Shawnee, KS 66226-3553

Mailing address

22742 Midland Dr
Shawnee, KS 66226-3553
Phone (913) 441-2293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120907000682 KS Part B Supplier - Clinic/Group Practice 8224286703 Receives reassigned benefits from 9 practitioners
Practice locations: Shawnee, KS

National Provider Directory

National Provider Directory

Locations

2625 Butterfield Rd
Oak Brook, IL 60523
Phone (630) 528-3835

22742 Midland Dr
Shawnee, KS 66226
Phone (913) 441-2293

19701 W 65th Ter
Shawnee, KS 66218
Phone (913) 270-0469

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1710257928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22742 MIDLAND DR",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263553",
            "telephone_number": "913-441-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22742 MIDLAND DR",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263553",
            "telephone_number": "913-441-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWORKS INTEGRATIVE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "GIANFORTE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-441-2293",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.