Organization Active NPI

True Lifestyle Medicine Clinic, LLC

  • Medical Specialty Clinic/Center
  • Davenport, IA
National Provider Identifier
1740671387
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
34772 Issued in IA
Legal business name
TRUE LIFESTYLE MEDICINE CLINIC, LLC
Practice address
2320 Windsor CT
Davenport, IA 52807-1438
Phone
(563) 940-4641
Fax
(888) 959-3948
NPI assigned
Feb 17, 2015
Last updated
Feb 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Dr. Cheryl True, MDNPI 1104891712
Title
Physician
Phone
(563) 940-4641

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 34772 IA Primary

Addresses

Primary practice location

2320 Windsor CT
Davenport, IA 52807-1438

Mailing address

2320 Windsor CT
Davenport, IA 52807-1438
Phone (563) 940-4641

Other identifiers 1

IdentifierTypeStateIssuer
1242487MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1740671387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 WINDSOR CT",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071438",
            "telephone_number": "563-940-4641",
            "fax_number": "888-959-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 WINDSOR CT",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071438",
            "telephone_number": "563-940-4641",
            "fax_number": "888-959-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUE LIFESTYLE MEDICINE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "TRUE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "563-940-4641",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IA",
            "license": "34772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1242487",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.