MEDICARE: LIVE OAK CLAIM SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1740126309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVE OAK CLAIM SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	5830 E 2ND ST STE 35146
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82609-4308
Country	:	US
Telephone Number	:	307-215-9888
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 PROFESSIONAL PKWY
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34240-8457
Country	:	US
Telephone Number	:	307-215-9888
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	BEAU JEPPESEN
Credential	:
Telephone Number	:	801-703-5073

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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