LIVEWELL FAMILY CLINIC LLC (NPI# 1649760075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649760075 |
| Entity Type | Organization |
| Organization Name | LIVEWELL FAMILY CLINIC LLC |
| Practice Address |
3611 Branch Ave Ste 404 Temple Hills MD 20748 |
| Mailing Address |
3611 Branch Ave Ste 4043611 Temple Hills MD 20748-1242 |
| Practice Telephone | 2407192587 |
| Practice Fax Number | 2408302320 |
| Mailing Telephone | 2407192587 |
| Mailing Fax Number | 2408302320 |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-07-12 |
| Authorized Official Name | BETTY E ARKHURST (SECRETARY) |
| Authorized Official Telephone | 3016130529 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
R190895 | MD | Ambulatory Health Care Facilities |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3611 BRANCH AVE STE 404 |
| City | TEMPLE HILLS |
| State | MD |
| Zip Code | 20748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316579873 | Brightway Professionals and Associates | Clinic/Center | 4810 St.barnabas Rd, Suite 201, Temple Hills, MD 20748 | 2020-02-12 |
| 1235783085 | Jasmine Lenee Carter | Behavior Technician | 5506 Clothier St., Temple Hills, MD 20748 | 2019-07-30 |
| 1346785474 | Cardinal Health Care Solution LLC | Home Health | 4905 Faith Crossin Ct, Templehills, MD 20748 | 2016-12-28 |
| 1205370095 | Crystal Hughes | Specialist | 6337 Old Branch Ave Shop 37, Camp Springs, MD 20748 | 2016-12-13 |
| 1417385444 | Ibhs LLC | Substance Abuse Rehabilitation Facility | 5000 Barnabas Road, Ct2, Temple Hills, MD 20748 | 2013-10-30 |
| 1063848703 | Oluwagbenga Jegede | Home Health Aide | 6516 Allentown Rd, Temple Hills, MD 20748 | 2013-09-25 |
| 1184067514 | Vijaya Lakshmi Alla | Family Medicine | 6014 Old Branch Avenue, Temple Hills, MD 20748 | 2013-04-16 |
| 1215178959 | Patricia Ann Carter | Counselor | 5121 Henderson Road, Suite 101, Temple Hills, MD 20748 | 2009-03-10 |
| 1427220888 | Emerging Vision | Technician/Technologist | 3801 D Branch Ave, Iverson Mall, Temple Hills, MD 20748 | 2008-03-26 |
| 1366566432 | Steven R Tillman | Counselor | 4400 Stamp Road, Suite # 208, Temple Hills, MD 20748 | 2007-03-16 |
| Find all providers in zip 20748 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477811800 | Calista Ogbu | Nurse Practitioner | 4302 Saint Barnabas Rd Ste G, Temple Hills, MD 20748-1842 | 2012-04-23 |
| 1518509488 | Carole Nguekam | Nurse Practitioner | 4333 Old Branch Ave, Temple Hills, MD 20748-1848 | 2019-10-11 |
| 1154819977 | Johanese Sandy | Nurse Practitioner | 4467 Old Branch Ave Ste 207, Temple Hills, MD 20748 | 2018-04-26 |
| 1508361510 | Romtin Sharolli | Nurse Practitioner | 4333 Old Branch Ave, Temple Hills, MD 20748 | 2018-03-30 |
| 1811051972 | Manyahlishal Telahun | Nurse Practitioner | 6104 Old Branch Avenue, Temple Hills, MD 20748-2518 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730318 | My Clinical Coordinator LLC | Nurse Practitioner | 11720 Belsville Drive, Suite 500-a44, Beltsville, MD 20705 | 2020-11-04 |
| 1639779432 | Daniel A Mesfin | Nurse Practitioner | 14528 Fairdale Rd, Silver Spring, MD 20905-6526 | 2020-10-30 |
| 1043810849 | Olushola Taiwo Adekoya | Nurse Practitioner | 6909 Crossfield Ct, Clarksville, MD 21029-1749 | 2020-10-29 |
| 1598365082 | Chibuzor Susan Igolo | Nurse Practitioner | 4494 N Palmer Rd N, Bethesda, MD 20814 | 2020-10-26 |
| 1013516640 | Heather Mekins | Nurse Practitioner | 721 Bridge Dr, Pasadena, MD 21122-4553 | 2020-10-24 |
| 1962001818 | Shannon Nicole Martin | Nurse Practitioner | 924 Seton Dr # C, Cumberland, MD 21502-1851 | 2020-10-21 |
| 1336748672 | Taneka Lee | Nurse Practitioner | 5415 Force Rd, Baltimore, MD 21206-4617 | 2020-10-19 |
| 1811596281 | Winners Healthcare Services LLC | Nurse Practitioner | 1529 Winfields Ln, Gambrills, MD 21054-1127 | 2020-10-18 |
| 1518565324 | Kanisha Tonya Aaron | Nurse Practitioner | 9401 Groveton Cir Apt 311, Owings Mills, MD 21117-8299 | 2020-10-14 |
| 1891393765 | Winsome Boykin | Nurse Practitioner | 7231 Parkway Dr, Hanover, MD 21076-1788 | 2020-10-13 |
| Find all providers with the same taxonomy | ||||
| City | TEMPLE HILLS |
| Zip Code | 20748 |
Please comment or provide details below to improve the information on LIVEWELL FAMILY CLINIC LLC.
| 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.