Organization Active NPI

Life Health

  • Health Service Clinic/Center
  • Powder Springs, GA
National Provider Identifier
1023543162
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
RN167846 Issued in GA
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

Updated by the provider on Apr 26, 2017

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
208D00000XMedicaidGA

National Provider Directory

National Provider Directory

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": "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.

Verify at the official NPI Registry.