NPIMap

Organization Active NPI

Lifewise Associates LLC

  • Clinic/Center
  • Devils Lake, ND
National Provider Identifier
1871088674
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIFEWISE ASSOCIATES LLC
Practice address
210 Highway 2 W Ste 10
Devils Lake, ND 58301-2913
Phone
(701) 662-1046
Fax
(866) 528-9548
NPI assigned
Jun 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Authorized official

Name
Darrin Cox, LICSWNPI 1780732297
Title
Co Owner
Phone
(701) 662-1046

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

210 Highway 2 W Ste 10
Devils Lake, ND 58301-2913

Mailing address

210 Highway 2 W Ste 10
Devils Lake, ND 58301-2913
Phone (701) 662-1046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190625002236 ND Part B Supplier - Clinic/Group Practice 2264784008 Receives reassigned benefits from 11 practitioners
Practice locations: Devils Lake, ND

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1871088674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 HIGHWAY 2 W STE 10",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012913",
            "telephone_number": "701-662-1046",
            "fax_number": "866-528-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HIGHWAY 2 W STE 10",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012913",
            "telephone_number": "701-662-1046",
            "fax_number": "866-528-9548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWISE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-25",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "DARRIN",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "701-662-1046",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.