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HEALTHWISE ADVANCED PRACTICE PARTNERS NPI 1801524319


NPI Information

NPI: 1801524319
Provider Name: HEALTHWISE ADVANCED PRACTICE PARTNERS
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 26D2257926

Address:
3490 HOLLENBERG DR
BRIDGETON, MO
ZIP 63044
Phone: (314) 500-0716
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HEALTHWISE ADVANCED PRACTICE PARTNERS is a clinic center in Bridgeton, MO. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). HEALTHWISE ADVANCED PRACTICE PARTNERS NPI is 1801524319. The provider is registered as an organization entity type.

The provider's business location address is:

3490 HOLLENBERG DR
BRIDGETON, MO
ZIP 63044-429
Phone: (314) 500-0716
Fax: (314) 463-0755

The provider's authorized official is Laquita Danielle Lewis .
The authorized official title is Owner and has the following contact phone number (314) 624-1317.

The CLIA number assigned to this NPI record is 26D2257926 - other - dot exam, general labs se with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/11/2022 and was last updated on 8/11/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11669743241OTHERMISSOURINPI
2101740097MEDICAIDMISSOURI

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: 5/5/2024

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