Well Life Family Medicine, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

3012 Issued in OR

Legal business name

WELL LIFE FAMILY MEDICINE, LLC

Doing business as

Willamette Valley Weight Loss, LLC

Practice address

1174 Cornucopia St NW Ste 240
Salem, OR 97304

Phone

(971) 301-4411

Fax

(971) 999-7006

NPI assigned

Dec 19, 2017

Last updated

Jan 7, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Aubrey Lynn Harding, NDNPI 1487024998

Title

Owner

Phone

(971) 301-4411

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Willamette Valley Weight Loss, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

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

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21276/brand/1/csg/1/fhir/r4

Practitioners 24

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.

• Emily R Charlton, FNP

  • Nurse Practitioner
  • Hillsboro, OR
  • NPI 1407330889
  Medicare reassignment Care Compare group NPD
• Isaac Anson Lichtenstein, MD, RN

  • Family Medicine Physician
  • Corvallis, OR
  • NPI 1962147603
  Medicare reassignment Care Compare group NPD
• David John Ramsay

  • Mental Health Counselor
  • Hillsboro, OR
  • NPI 1447927314
  Medicare reassignment Care Compare group NPD
• Denise L Tobe, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1235503277
  Medicare reassignment Care Compare group NPD
• Emani Cheng, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mangonia Park, FL
  • NPI 1215682919

  OR

  Medicare reassignment Care Compare group NPD
• Aaron Erez, D.O.

  • Family Medicine Physician
  • La Jolla, CA
  • NPI 1184018079

  OR

  Medicare reassignment Care Compare group NPD
• Alexander Goldman, PA

  • Physician Assistant
  • Seattle, WA
  • NPI 1568068492

  OR

  Medicare reassignment Care Compare group NPD
• Dale Lachance, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Dover, OH
  • NPI 1568937563

  OR, Single Specialty

  Medicare reassignment Care Compare group NPD
• Sreshtha Singh, D.O.

  • Internal Medicine Physician
  • Bluffton, SC
  • NPI 1174214985

  OR

  Medicare reassignment Care Compare group NPD
• Patrick Testa, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilbert, AZ
  • NPI 1588303937

  OR

  Medicare reassignment Care Compare group NPD
• Evelin Dacker, M.D.

  • Family Medicine Physician
  • Salem, OR
  • NPI 1861479396
  Medicare reassignment NPD
• Aubrey Lynn Harding, N.D.

  • Naturopath
  • Salem, OR
  • NPI 1487024998
  NPD Authorized official

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546819200000",
    "number": "1760998355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 CORNUCOPIA ST NW STE 240",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043193",
            "telephone_number": "971-301-4411",
            "fax_number": "971-999-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 CORNUCOPIA ST NW STE 240",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97304",
            "telephone_number": "971-301-4411",
            "fax_number": "971-999-7006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2651 Commercial St SE Ste 1",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973024872",
            "country_code": "US",
            "telephone_number": "971-301-4411",
            "fax_number": "971-999-7006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1675 SW Marlow Ave Ste 307",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972255105",
            "country_code": "US",
            "telephone_number": "971-301-4411",
            "fax_number": "971-999-7006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "858 Commercial St NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973011016",
            "country_code": "US",
            "telephone_number": "971-301-4411",
            "fax_number": "971-999-7006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELL LIFE FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2019-01-07",
        "status": "A",
        "authorized_official_last_name": "HARDING",
        "authorized_official_first_name": "AUBREY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-301-4411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "3012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500694138",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willamette Valley Weight Loss, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Weirich
• Shelby Jean Weisbrodt
• Linda Jean Weisensee
• Welbehealth Oregon Pace, LLC
• Carissa Noelle Welding
• Wellbe Oregon PC
• John Henry Weller, FNPC
• Toni-Ann Wellington
• Jillany Noel Wellman, LMFTA
• Mary Wellman, CLT, LMT

• Clinic/Center in Salem, OR
• Providers in Salem, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.