MEDICARE: BEYOND WELLNESS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	111N00000X	Chiropractor
2	261QM1300X	Multi-Specialty Clinic/Center
3	133V00000X	Registered Dietitian
4	261QP2300X	Primary Care Clinic/Center
5	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1730906637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 401477
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89140-1477
Country	:	US
Telephone Number	:	833-759-8720
Fax Number	:	833-973-4752

Provider Business Practice Location Address
First Line	:	3530 VOLUNTEER BLVD STE 100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044-1857
Country	:	US
Telephone Number	:	833-759-8720
Fax Number	:	833-438-5615

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LISA ANDERSON
Credential	:
Telephone Number	:	833-759-8720

Provider Enumeration Date	:	09/23/2024
Last Update Date	:	03/15/2026

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