Shamrock Health and Wellness Clinic, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SHAMROCK HEALTH AND WELLNESS CLINIC, LLC

Practice address

100 S Main St
North Liberty, IN 46554-7705

Phone

(574) 656-7625

NPI assigned

Jul 22, 2019

Last updated

Sep 4, 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

Tamera Andrews

Title

Owner

Phone

(574) 656-7526

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567555200000",
    "number": "1912550765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 769",
            "city": "NORTH LIBERTY",
            "state": "IN",
            "postal_code": "465540769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S MAIN ST",
            "city": "NORTH LIBERTY",
            "state": "IN",
            "postal_code": "465547705",
            "telephone_number": "574-656-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMROCK HEALTH AND WELLNESS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-09-04",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "TAMERA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-656-7526"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty Center Family Medicine
• Liberty Township Trustee
• James Mitchell, OTR
• Justine Marie Prikosovich, PTA, CNS
• Tiffany Therese Richards, APRN FNP-BC
• Anita Ellen Shipley
• Sara Marie Singleton, FNP

• Primary Care Clinic/Center in North Liberty, IN
• Providers in North Liberty, IN by specialty
• Primary Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.