Organization Active NPI

Med Spa at Enid Live Well

  • Endocrinology, Diabetes & Metabolism Physician
  • Enid, OK
National Provider Identifier
1902437346
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
MED SPA AT ENID LIVE WELL
Practice address
2111 N Van Buren St
Enid, OK 73703-2524
Phone
(580) 233-4300
Fax
(580) 350-6401
NPI assigned
Feb 3, 2020
Organization subpart
Yes
Parent organization
VIKI WHITEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Authorized official

Name
Dr. Viki Sharlain White, DC
Title
Ceo
Phone
(580) 233-4300

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary
Health Service Clinic/Center 261QH0100X
Multi-Specialty Clinic/Center 261QM1300X
Pain Clinic/Center 261QP3300X

Addresses

Primary practice location

2111 N Van Buren St
Enid, OK 73703-2524

Mailing address

2111 N Van Buren St
Enid, OK 73703-2524
Phone (580) 233-4300

Other names 1

  • Enid Live Well Other name

National Provider Directory

National Provider Directory
Part of
Viki Sharlain Resler CH

Locations

2111 N Van Buren St
Enid, OK 73703
Phone (580) 233-0430

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1902437346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 N VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737032524",
            "telephone_number": "580-233-4300",
            "fax_number": "580-350-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 N VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737032524",
            "telephone_number": "580-233-4300",
            "fax_number": "580-350-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED SPA AT ENID LIVE WELL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIKI WHITE",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "VIKI",
        "authorized_official_middle_name": "SHARLAIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-233-4300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enid Live Well",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Enid Live Well",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.