COLLEEN SHACKELFORD, LLC – NPI #1689744963
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

COLLEEN SHACKELFORD, LLC is a provider located in BOISE, ID. NPPES has assigned the NPI number 1689744963 to COLLEEN SHACKELFORD, LLC on November 08, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “COLLEEN SHACKELFORD, LLC” is a dba name, the actual legal business name for this organization is CENTER FOR LIFETIME HEALTH. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 3 years ago on Jul 25, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COLLEEN SHACKELFORD, LLC below.

NPI Profile for
CENTER FOR LIFETIME HEALTH

NPI Number
1689744963
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CENTER FOR LIFETIME HEALTH
Doing Business As (dba): COLLEEN SHACKELFORD, LLC
Primary location
300 E BANNOCK ST
BOISE, ID 83712
Phone: (208) 342-7400 Fax: (208) 342-1879
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
COLLEEN SHACKELFORD
OWNER
Phone: (208) 342-7400
Updated
Certification Date
Jul 25, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)		 ID M5741

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.