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LIFEWAY HEALTH & WELLNESS LLC
NPI 1598443723
Clinic/Center - Primary Care in Maple Grove, MN

Active since July 07, 2023CLIA 24D2288544 · Waiver
6469 SYCAMORE CT N, MAPLE GROVE, MN 55369(763) 276-9443(888) 440-6946 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 11, 2023, Jul 7, 2023 (2 updates tracked since 2023).

About Lifeway Health & Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFEWAY HEALTH & WELLNESS LLC (NPI 1598443723) is a healthcare organization registered as a primary care in Maple Grove, Minnesota and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through August 27, 2027 and lists Stacy Woodard, Ceo, as its authorized official.

NPPES Registry Identity

NPI1598443723
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameLIFEWAY HEALTH & WELLNESS LLC
Location Address6469 SYCAMORE CT NMaple Grove, MN 55369-6028
Mailing Address6469 Sycamore Ct NMaple Grove, MN 55369-6028 · (763) 276-9443 · Fax (888) 440-6946
Phone(763) 276-9443
Fax(888) 440-6946
Organization SubpartNo
Authorized OfficialStacy WoodardCeo · (763) 438-3814
Enumeration DateJuly 7, 2023
Last NPPES UpdateJune 30, 20262 updates tracked since enumeration
NPPES CertifiedJune 30, 2026
✔ NPI 1598443723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
6469 SYCAMORE CT N, Maple Grove, MN 55369
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lifeway Health & Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Lifeway Health & Wellness LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Erika Kuis, FNP
Nurse Practitioner
NPI 1720546773
6469 SYCAMORE CT N
Maple Grove, MN 55369
(763) 276-9443
✔ PECOS✔ Accepts MedicareSame address
Stacy Woodard
Nurse Practitioner
NPI 1740776707
6469 SYCAMORE CT N
Maple Grove, MN 55369
(763) 276-9443
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2288544

Lifeway Health & Wellness · Maple Grove, MN
Active · expires Aug 27, 2027
CLIA Number24D2288544
Laboratory TypePractitioner Other
Certificate Effective DateAugust 28, 2025
Certificate Expiration DateAugust 27, 2027
Laboratory DirectorStacy A. Woodard
Laboratory Phone(763) 276-9443
Laboratory LocationLifeway Health & Wellness6469 Sycamore Ct N, Maple Grove, MN 55369
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifeway Health & Wellness LLC's NPI number?

The NPI number for Lifeway Health & Wellness LLC is 1598443723. It was assigned to this organization in the NPPES registry on July 7, 2023.

Where is Lifeway Health & Wellness LLC located?

Lifeway Health & Wellness LLC is located at 6469 Sycamore Ct N, Maple Grove, MN 55369. The listed phone number is (763) 276-9443.

What is Lifeway Health & Wellness LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Lifeway Health & Wellness LLC enrolled in Medicare?

Yes. Lifeway Health & Wellness LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lifeway Health & Wellness LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Lifeway Health & Wellness LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lifeway Health & Wellness LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2288544) is associated with this NPI, valid through August 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lifeway Health & Wellness LLC was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.