Lifestyle Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

003822 Issued in MO

Legal business name

LIFESTYLE WELLNESS CENTER LLC

Practice address

307 Main Street
Pineville, MO 64856

Phone

(417) 223-4103

Fax

(417) 223-4102

NPI assigned

Apr 25, 2008

Last updated

Apr 25, 2008By 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

Mrs. Lesli G Smith

Title

Owner

Phone

(417) 223-4103

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Lifestyle Wellness Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lifestyle Wellness Center, LLC

  • Nutrition Chiropractor
  • Pineville, MO
  • NPI 1790811784
  NPD tax ID

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.

• Norman Alan Smith, DC

  • Chiropractor
  • Pineville, MO
  • NPI 1104028687
  NPD (past)

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1780859272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "PINEVILLE",
            "state": "MO",
            "postal_code": "648560037",
            "telephone_number": "417-223-4103",
            "fax_number": "417-223-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 MAIN STREET",
            "city": "PINEVILLE",
            "state": "MO",
            "postal_code": "64856",
            "telephone_number": "417-223-4103",
            "fax_number": "417-223-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LESLI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-223-4103",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "003822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2106860001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heart and Vascular Care
• Kylie Marie Helm
• Megan Nicole Knox, D.C.
• Diane Marie Kunkel, LPC/NCC
• Judith G Lewallen, FNP
• Lifestyle Wellness Center, LLC
• Kayla Nicole Loving
• Rachael Gabriela McCann, PHARMD
• Gilbert R Morgan, D.C.
• Gary David Neymeyer, OD

• Chiropractor in Pineville, MO
• Providers in Pineville, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.