Life Cycle Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

LIFE CYCLE PEDIATRICS, LLC

Practice address

150 Medical Way Ste B
Riverdale, GA 30274-2533

Phone

(770) 692-2800

Fax

(770) 692-2804

NPI assigned

Sep 1, 2021

Organization subpart

No

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

Authorized official

Name

Gwendolyn Williams

Title

Office Manager

Phone

(404) 228-0601

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

Life Cycle Pediatrics4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Life Cycle Pediatrics

  • Pediatrics Physician
  • Riverdale, GA
  • NPI 1063688224
  NPD tax ID
• Life Cycle Pediatrics, LLC

  • Pediatrics Physician
  • East Point, GA
  • NPI 1134331952
  NPD tax ID
• Life Cycle Pediatrics, LLC

  • Pediatrics Physician
  • Decatur, GA
  • NPI 1508363128
  NPD tax ID

Locations

Practitioners 1

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

• Anne Sirey Sigouin, CNM

  • Advanced Practice Midwife
  • East Point, GA
  • NPI 1346358777
  NPD (past)

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1003584327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2739 FELTON DR",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443603",
            "telephone_number": "404-766-8371",
            "fax_number": "404-767-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MEDICAL WAY STE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742533",
            "telephone_number": "770-692-2800",
            "fax_number": "770-692-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CYCLE PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "404-228-0601"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578526539",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "support@lifecycleobgyn.com",
            "affiliation": "N",
            "endpointDescription": "Practice email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2739 Felton Dr",
            "city": "East Point",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303443603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul Harvey Liebman, M.D.
• Life Changers Community Empowerment Enterprises, Inc
• Life Cycle OB/GYN, LLC
• Life Cycle OB/GYN, LLC
• Life Cycle Pediatrics
• Life Orthopaedic & Spine Center
• Life Rediscovery Center, LLC
• Lifestyle Therapy Center, LLC
• James L Lindsey
• Michelle Little

• Pediatrics Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.