LIVE WELL HEALTH LLC NPI 1548627847

NPI Record

The following NPI record includes the field values provided by the NPPES as well as the field definition as published in the Federal Register. The complete NPI record is also available for download in text, csv and xml formats.

Field Name Field Value Definition 1
NPI 1548627847 The first name of the provider, if the provider is an individual.
Entity Type Code 2 The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Employer Identification Number EIN The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Organization Name Legal Business Name LIVE WELL HEALTH LLC The city name in the location address of the provider being identified.
Provider First Line Business Practice Location Address 15565 NORTHLAND DR The State code in the location of the provider being identified.
Provider Second Line Business Practice Location Address SUITE 103W-B The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address City Name SOUTHFIELD The country code in the location address of the provider being identified.
Provider Business Practice Location Address State Name MI The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 48075 The fax number associated with the location address of the provider being identified.
Provider Business Practice Location Address Country Code If outside U S US The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Practice Location Address Telephone Number 2488092094 The date that a record was last updated or changed.
Provider Enumeration Date 1/19/2016 The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 1/19/2016 The date that a record was last updated or changed.
Authorized Official Last Name TEZERA The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name SISSY The first name of the authorized official.
Authorized Official Title or Position OWNER The title or position of the authorized official.
Authorized Official Telephone Number 2488092094 The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1 261Q00000X This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1 Y This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Organization Subpart N Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Name Prefix Text MR. The prefix used in the name of the authorized official associated with the provider's NPI record. Examples include Mr., Ms., Mrs., Dr., or other common professional or personal prefixes.
Authorized Official Credential Text DC The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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