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PRESTIGE WELLNESS CLINIC
NPI 1720867153
Physician Assistant - Medical in Rigby, ID

Active since September 25, 2023

NPPES record last updated: September 25, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Prestige Wellness Clinic NPPES

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

PRESTIGE WELLNESS CLINIC (NPI 1720867153) is a healthcare organization registered as a medical in Rigby, Idaho and active in the NPI registry since September 2023. The organization lists Levi Hansen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1720867153
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NamePRESTIGE WELLNESS CLINIC
Location Address3749 E 343 NRigby, ID 83442-5326
Mailing Address3749 E 343 NRigby, ID 83442-5326 · (208) 705-9800
Phone(208) 705-9800
Organization SubpartNo
Authorized OfficialLevi HansenCeo · (208) 705-9800
Enumeration DateSeptember 25, 2023
NPPES CertifiedSeptember 25, 2023
✔ NPI 1720867153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
3749 E 343 N, Rigby, ID 83442
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRESTIGE KETAMINE PC
Clinic/Center (Infusion Therapy)
3749 E 343 N
RIGBY, ID 83442
Jefferson County (208) 705-9800

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 Prestige Wellness Clinic's NPI number?

The NPI number for Prestige Wellness Clinic is 1720867153. It was assigned to this organization in the NPPES registry on September 25, 2023.

Where is Prestige Wellness Clinic located?

Prestige Wellness Clinic is located at 3749 E 343 N, Rigby, ID 83442. The listed phone number is (208) 705-9800.

What is Prestige Wellness Clinic's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Prestige Wellness Clinic was last updated on September 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.