Sir Isaac LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SIR ISAAC LLC

Doing business as

Future health and wellness

Practice address

18275 N 59TH Ave Ste 128
Glendale, AZ 85308-1252

Phone

(763) 639-1269

Fax

(602) 938-2283

NPI assigned

Jun 18, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Massa Kiawoin Lavant, OWNER

Title

Manager

Phone

(763) 639-1269

Specialties & licenses 1

Addresses

Other names 1

• Future health and wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

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

Practitioners 1

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

• Mildred Denise Kiawoin, FNP

  • Family Nurse Practitioner
  • Saint Paul, MN
  • NPI 1710592530

  AZ

  Medicare reassignment NPD

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1750124459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE STE 128",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081252",
            "telephone_number": "763-639-1269",
            "fax_number": "602-938-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE STE 128",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081252",
            "telephone_number": "763-639-1269",
            "fax_number": "602-938-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIR ISAAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "LAVANT",
        "authorized_official_first_name": "MASSA",
        "authorized_official_middle_name": "KIAWOIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "763-639-1269",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Future health and wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Future health and wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shivani Singh, PHARM.D.
• Tarunjit Singh
• Vikram Boolchand Singh, M.D.
• Zabita Singh, M.D.
• Tanya Singleton
• Tiana Rae Siragusa, PA-C
• Sirena Health and Wellness LLC
• Clementine Sirri Nde
• Rebecca Sisneros
• Matthew Sizemore, PA

• Health Service Clinic/Center in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Health Service Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.