Active NPI
Life Health
- Health Service Clinic/Center
- Powder Springs, GA
National Provider Identifier
1023543162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- License
- RN167846
- Legal business name
- LIFE HEALTH
- Practice address
- 3382 Knighton RDG
Powder Springs, GA 30127-2160 - Phone
- (770) 780-7825
- NPI assigned
- Apr 26, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sarah Gregory
- Title
- Recruiter
- Phone
- (303) 730-1902
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | RN167846 | GA | Primary |
Addresses
Primary practice location
3382 Knighton RDG
Powder Springs, GA 30127-2160
Mailing address
3382 Knighton RDG
Powder Springs, GA 30127-2160
Phone (770) 780-7825
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208D00000X | Medicaid | GA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Health Nurse Practitioner
- Lithia Springs, GA
- NPI 1407384977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493164800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1493164800000",
"number": "1023543162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3382 KNIGHTON RDG",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301272160",
"telephone_number": "770-780-7825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3382 KNIGHTON RDG",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301272160",
"telephone_number": "770-780-7825"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2017-04-26",
"last_updated": "2017-04-26",
"status": "A",
"authorized_official_last_name": "GREGORY",
"authorized_official_first_name": "SARAH",
"authorized_official_title_or_position": "RECRUITER",
"authorized_official_telephone_number": "303-730-1902"
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "GA",
"license": "RN167846",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208D00000X",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Powder Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.