TOTAL LIFE CLINIC PLLC (NPI# 1467816199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467816199 |
| Entity Type | Organization |
| Organization Name | TOTAL LIFE CLINIC PLLC |
| Practice Address |
2311 Park Ave Ste 6 Burley ID 83318-2104 |
| Practice Telephone | 2088786413 |
| Practice Fax Number | 2088786417 |
| Mailing Telephone | 2088786413 |
| Mailing Fax Number | 2088786417 |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2017-02-09 |
| Authorized Official Name | LACIE ASHER (FNP-C) |
| Authorized Official Telephone | 2088786413 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1609107176 | 05 |
| Street Address |
2311 PARK AVE STE 6 |
| City | BURLEY |
| State | ID |
| Zip Code | 83318-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902366834 | Pain & Spine Consultants | Clinic/Center | 1344 Hiland Avenue, Ste A, Burley, ID 83318 | 2019-03-25 |
| 1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
| 1831654243 | Mini-cassia Hearts 4 Seniors | In Home Supportive Care | 135 East 23rd Drive, Burley, ID 83318 | 2019-02-11 |
| 1841760493 | Burley Family Dental Pllc | Dentist | 2200 Parke Ave Ste 2, Burley, ID 83318 | 2018-11-27 |
| 1831634823 | Skye Fahnlander | Occupational Therapy Assistant | 2303 Parke Ave, Burley, ID 83318 | 2016-12-29 |
| 1285024497 | Albion Valley Health Clinic Inc. | Clinic/Center | 400 West 5th Street, Burley, ID 83318 | 2015-01-26 |
| 1124372370 | A Plus Solutions Center | Clinic/Center | 2311 Parke Ave. Unit 3, Suite 12, Burley, ID 83318 | 2012-11-08 |
| 1831442805 | A Plus Solutions Developmental Center LLC | Day Training, Developmentally Disabled Services | 2251 Overland Avenue, Suite Number 5, Burley, ID 83318 | 2012-10-16 |
| 1619258159 | Keleah Margrete Goldammer | Occupational Therapist | 2303 Parke Avenue, Burley, ID 83318 | 2011-08-29 |
| 1932490984 | Tamera Chatburn | Counselor | 531 East 5th St., Preferred Child and Family Services, Burley, ID 83318 | 2011-04-26 |
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| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1235618331 | Healthworks Med Group of Colorado P C | Clinic/Center | 126 E 21st St, Burley, ID 83318-2551 | 2018-08-09 |
| 1285024497 | Albion Valley Health Clinic Inc. | Clinic/Center | 400 West 5th Street, Burley, ID 83318 | 2015-01-26 |
| 1659915593 | Sterling Provider Group | Clinic/Center | 1404 Pomerelle Ave Ste A1, Burley, ID 83318-2013 | 2019-11-04 |
| 1467961664 | Sterling Physician Group Pllc | Clinic/Center | 1404 Pomerelle Ave Ste A1, Burley, ID 83318-2013 | 2017-09-20 |
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| 1275186835 | Bella Family Healthcare & Aesthetics | Clinic/Center | 1545 E Leighfield Dr Ste 100, Meridian, ID 83646-5371 | 2019-07-22 |
| 1902387285 | Integrative Health Solutions Pllc | Clinic/Center | 1215 Michigan St Ste B, Sandpoint, ID 83864-5014 | 2018-08-24 |
| 1427537927 | Gem State Family Health Care Pllc | Clinic/Center | 496 Shoup Ave W Ste E, Twin Falls, ID 83301-5043 | 2018-08-07 |
| 1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
| 1073031118 | Clover Creek Medical | Clinic/Center | 175 North Main Street, Bloomington, ID 83223-8322 | 2017-09-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.