Lwafp PC Inc

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

LWAFP PC INC

Doing business as

Living Water Adult Family Practice

Practice address

181 NW Bunnell Ave
Grants Pass, OR 97526-6012

Phone

(541) 474-9400

NPI assigned

Aug 7, 2008

Last updated

Aug 7, 2008By 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

Cynthia Mahoney, MSN, FNPNPI 1174571186

Title

President

Phone

(541) 474-9400

Specialties & licenses 1

Addresses

Other names 1

• Living Water Adult Family Practice Doing business as

Practitioners 2

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.

• Cynthia Marie Mahoney, FNP

  • Adult Health Nurse Practitioner
  • Grants Pass, OR
  • NPI 1174571186
  Authorized official Same address or phone
• Michael George Pruner, ARNP

  • Adult Health Nurse Practitioner
  • Cave Junction, OR
  • NPI 1356472161
  NPD (past)

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1992951107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1925",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975280163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 NW BUNNELL AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975266012",
            "telephone_number": "541-474-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LWAFP PC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-474-9400",
        "authorized_official_credential": "MSN, FNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Water Adult Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Minette Cruz Lukban, MD
• Lung Clinic Center for Sleep Medicine
• Rebecca Lupescu
• Andrew Donald Luther, M.D.
• Collette Marie Luttmer, M.D.
• Brandi Ariel Lynch, LMT
• Mark Alan Lynch, FNP
• Lynda Spangler,MSW, LCSW, PC
• Lynn Ann Development, LLC (CountrySide Village)
• Justin Harrison Lyons, CADCII QMHAII CRMII

• Adult Health Nurse Practitioner in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.