NPIMap

Organization Active NPI

Lifecare Wellness Psychiatric Group

  • Psychiatric/Mental Health Nurse Practitioner
  • Tuscaloosa, AL
National Provider Identifier
1003438425
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LIFECARE WELLNESS PSYCHIATRIC GROUP
Practice address
653 Helen Keller Blvd
Tuscaloosa, AL 35404-2983
Phone
(205) 258-2249
Fax
(205) 293-5516
NPI assigned
May 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ella WilliamsonNPI 1740568443
Title
Owner
Phone
(205) 391-7534

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

653 Helen Keller Blvd
Tuscaloosa, AL 35404-2983

Mailing address

216 2ND St SW
Gordo, AL 35466-2221
Phone (205) 391-7534

Other identifiers 1

IdentifierTypeStateIssuer
2019045211OtherANCC

Other names 1

  • Lifecare Wellness Psychiatric Group Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Tuscaloosa

National Provider Directory

National Provider Directory

Locations

653 Helen Keller Blvd
Tuscaloosa, AL 35404
Phone (205) 553-9171

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1003438425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 2ND ST SW",
            "city": "GORDO",
            "state": "AL",
            "postal_code": "354662221",
            "telephone_number": "205-391-7534",
            "fax_number": "205-344-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 HELEN KELLER BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042983",
            "telephone_number": "205-258-2249",
            "fax_number": "205-293-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE WELLNESS PSYCHIATRIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "ELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-391-7534"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2019045211",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Tuscaloosa",
            "affiliation": "N",
            "address_1": "657 Helen Keller Blvd",
            "city": "Tuscaloosa",
            "state": "AL",
            "country_code": "US",
            "postal_code": "354042983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lifecare Wellness Psychiatric Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.