Live Well Health and Nutrition PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

LIVE WELL HEALTH AND NUTRITION PLLC

Practice address

4700 N Cloverdale Rd Ste 103
Boise, ID 83713-1067

Phone

(208) 392-8383

Fax

(208) 493-3062

NPI assigned

Nov 16, 2017

Last updated

Nov 16, 2017By 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

Denise Bahadar, NPNPI 1376899278

Title

NP, Owner

Phone

(208) 861-4677

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Denise R Bahadar, NP

  • Family Nurse Practitioner
  • Meridian, ID
  • NPI 1376899278
  NPD Authorized official

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510790400000",
    "number": "1952815623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 N CLOVERDALE RD STE 103",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131067",
            "telephone_number": "208-392-8383",
            "fax_number": "208-493-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N CLOVERDALE RD STE 103",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131067",
            "telephone_number": "208-392-8383",
            "fax_number": "208-493-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL HEALTH AND NUTRITION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A",
        "authorized_official_last_name": "BAHADAR",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "NP, OWNER",
        "authorized_official_telephone_number": "208-861-4677",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "NP-1169A",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Joseph Little, PA-S
• Terry M Little, D.O.
• Scott Litton
• Ruimin Liu, L.AC.
• Live Well Cpap and Medical Supply
• Livewell Health and Wellness LLC
• Living Hope Clinic Inc
• Living Independence Network Corporation
• Living Independently Forever, Inc.
• Living Independently Forever, Inc.

• Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.