Lifeway Training Institute Co

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LIFEWAY TRAINING INSTITUTE CO

Practice address

410 4TH St SE
Cairo, GA 39828-2775

Phone

(229) 403-9964

NPI assigned

Jan 23, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Julene Dorothy Smith, PMHNP-BCNPI 1083071898

Title

Owner

Phone

(229) 403-9964

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Julene Dorothy Smith, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cairo, GA
  • NPI 1083071898
  NPD Authorized official

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

{
    "created_epoch": "1642896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1003568817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 4TH ST SE",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398282775",
            "telephone_number": "229-403-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 4TH ST SE",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398282775",
            "telephone_number": "229-403-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWAY TRAINING INSTITUTE CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-23",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JULENE",
        "authorized_official_middle_name": "DOROTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-403-9964",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083071898",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD/ANTHEM",
            "identifier": "1083071898",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Lee, PT
• Brittany Leeks
• Noemi Lefranc Matta, M.D.
• Thomas K Leggett Jr, DMD
• Eric M Lehman, M.D.
• Brittni Nicole Linton
• Robyn Ashley Long, D.O.
• Lumis C. Brown DDS
• Jonathan P Lynch, MD
• S Kendra Thomaston Lynch, MD

• Psychiatric/Mental Health Nurse Practitioner in Cairo, GA
• Providers in Cairo, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.