180 HEALTH LIFESTYLE WELLNESS CENTERS (NPI# 1649815796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649815796 |
| Entity Type | Organization |
| Organization Name | 180 HEALTH LIFESTYLE WELLNESS CENTERS |
| Other Organization Name | 180 HEALTH MEDICAL AND WELLNESS CENTER |
| Practice Address |
1936 S Glenstone Ave Springfield MO 65804-2305 |
| Practice Telephone | 4178270450 |
| Mailing Telephone | 4178270450 |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2020-07-28 |
| Authorized Official Name | TARA MEEK (OWNER) |
| Authorized Official Telephone | 4178870340 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| 180 Health Medical and Wellness Center | Doing Business As Name - Organization |
| Street Address |
1936 S GLENSTONE AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-2305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609218510 | Ojv Inc. | General Practice | 4936 Laverna Rd, Springfield, IL 62707-9797 | 2013-07-19 |
| 1861742223 | Victoria J. Dow | General Practice | 948 Clocktower Drive, Springfield, IL 62704 | 2012-09-13 |
| 1386963429 | Care Station Medical Group, Pa | General Practice | 90 Us Highway 22, Springfield, NJ 07081-3110 | 2010-05-28 |
| 1164758892 | John Thomas Kelly | General Practice | 2105 Interlacken Dr, Springfield, IL 62704 | 2009-10-31 |
| 1972747574 | Bradley Bradshaw | General Practice | 1904 S Shady Hill Ln, Springfield, MO 65809-2601 | 2009-04-27 |
| 1265685515 | International Medical Center, Inc | General Practice | 5410 Port Royal Rd, Suite 100, Springfield, VA 22151-2314 | 2008-10-30 |
| 1518121565 | Robert Charles Woods | General Practice | 1522 S Cedar Ridge St, Springfield, MO 65809-2356 | 2008-07-17 |
| 1083817639 | Saul Wider | General Practice | 359 Spring Valley Rd, Springfield, PA 19064 | 2007-06-08 |
| 1669681938 | Shwee-tian Chou | General Practice | 517 Boston Rd, Springfield, MA 01109-1230 | 2007-05-22 |
| 1326116229 | Abdulkareem I Kraidy | General Practice | 6801 Backlick Rd, Springfield, VA 22150-3071 | 2006-12-01 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
Please comment or provide details below to improve the information on 180 HEALTH LIFESTYLE WELLNESS CENTERS.
| 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.