NPIMap

Organization Active NPI

Affinia Healthcare

Doing business as Lift for Life Academy

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
National Provider Identifier
1871069062
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AFFINIA HEALTHCARE
Doing business as
Lift for Life Academy
Practice address
1731 S Broadway
Saint Louis, MO 63104-4050
Phone
(314) 814-8700
Fax
(314) 814-8542
NPI assigned
Oct 16, 2018
Last updated
Oct 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Authorized official

Name
Corinthia Darcel Jamison
Title
Credentialing Coordinator
Phone
(314) 814-8531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1731 S Broadway
Saint Louis, MO 63104-4050

Mailing address

PO Box 551
Saint Louis, MO 63188-0551
Phone (314) 814-8531

Other names 1

  • Lift for Life Academy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Affinia Healthcare21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 3

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": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539648000000",
    "number": "1871069062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631880551",
            "telephone_number": "314-814-8531",
            "fax_number": "314-814-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 S BROADWAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631044050",
            "telephone_number": "314-814-8700",
            "fax_number": "314-814-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINIA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A",
        "authorized_official_last_name": "JAMISON",
        "authorized_official_first_name": "CORINTHIA",
        "authorized_official_middle_name": "DARCEL",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "314-814-8531"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lift for Life Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.