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Prestige Wellness Clinic

NPI 1720867153ActiveOrganization· Physician Assistant, Medical· Rigby, ID

Physician Assistant, Medical in Rigby, Idaho, registered in NPPES in September 2023. The authorized official on file is Levi Hansen, Ceo.

Overview

NPI1720867153
StatusActive
Entity typeOrganization
NPI issuedSep 25, 2023
Last updated in NPPESSep 25, 2023
Certified by providerSep 25, 2023

Specialties and licenses

TaxonomyCodeLicenseState
Physician Assistant, Medical Primary363AM0700X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other physician assistants in Rigby

All physician assistants in Idaho