Organization Active NPI

Lifespring, Inc

Doing business as LifeSpring Forensics Health Services

  • Federally Qualified Health Center (FQHC)
  • Jeffersonville, IN
National Provider Identifier
1043010077
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LIFESPRING, INC
Doing business as
LifeSpring Forensics Health Services
Practice address
432 E Court Ave
Jeffersonville, IN 47130-3414
Phone
(812) 280-2080
Fax
(812) 206-1243
NPI assigned
Mar 18, 2025
Last updated
Mar 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Authorized official

Name
Kristie Swoboda
Title
Practice Management Director
Phone
(812) 206-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

432 E Court Ave
Jeffersonville, IN 47130-3414

Mailing address

460 Spring St
Jeffersonville, IN 47130-3452
Phone (812) 280-2080

Other names 1

  • LifeSpring Forensics Health Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250421001860 IN Part A Provider - Federally Qualified Health Center (FQHC) 5294624508 Practice locations: Jeffersonville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043010077. Details of each certification follow.

Federally qualified health center certification: CCN C51089

Legal name
LIFESPRING, INC
Doing business as
LIFESPRING FORENSICS HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 2, 2025
Last certification
Apr 2, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
432 E Court Ave
Jeffersonville, IN 47130-3414

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Lifespring Mental Healt35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tiffany Pollock Individual W-2 Managing EmployeeCredentialing Sepcialist Mar 1, 2021
Alan Smock Individual Corporate OfficerTreasurer Jun 1, 2024
Jacalyn Young Individual Corporate OfficerSecretary Jun 1, 2024
Emily Stumler Individual Corporate OfficerMember Jun 1, 2024
Paul Kiger Individual Corporate OfficerMember Jun 1, 2024
Misty L Kannapel Gilbert Individual Corporate DirectorCoo Jun 1, 2024
Nick Clark Individual Corporate DirectorCfo Jun 1, 2024
Melissa Campbell Individual Corporate OfficerMember Jun 1, 2024
Darnell Jackson Individual Corporate OfficerChair Jun 1, 2024
Lifespring, Inc Organization, Jeffersonville, IN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 2024 100%
Margo Olson Individual Corporate OfficerMember Jun 1, 2024
Anne Beth Kenney Individual Corporate DirectorCeo Jun 1, 2024 100%
W-2 Managing EmployeeCeo Jun 1, 2024 100%
Wendy Broughton Individual Corporate OfficerMember Jun 1, 2024
Denise Eden Individual Corporate OfficerMember Jun 1, 2024
Rossina Sandoval Monsivais Individual Corporate OfficerChair-Elect Jun 1, 2024
Kenny Kavanaugh Individual Corporate OfficerMember Jun 1, 2024
Kristie Swoboda Individual Corporate DirectorPractice Manager Director Jun 1, 2024
Ray Oppel Individual Corporate OfficerMember Jun 1, 2024

Owners & managing parties with NPI records 16

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 16

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lifespring Community Medical ServicesJeffersonville, IN, CCN 151959 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Salem Community Medical ServicesSalem, IN, CCN 151979 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 15, 2016
Lifespring Adult Integrated Medical ServicesJeffersonville, IN, CCN 151037 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2019
Lifespring, IncJeffersonville, IN, CCN 151058 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 15, 1966
Austin Medical CenterAustin, IN, CCN 151081 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 16, 1966
New Albany Student Health CenterNew Albany, IN, CCN 151113 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
Jasper Community Medical ServicesJasper, IN, CCN 151115 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
Metro Mobile UnitNew Albany, IN, CCN 151156 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 16, 1966
Dale Community Medical ServicesDale, IN, CCN C51081 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2024
Lifespring Orleans Family HealthOrleans, IN, CCN C51090 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 24, 2024
Charlestown Community Medical ServicesCharlestown, IN, CCN C51088 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 21, 2024
Floyd Central Student Health CenterFloyds Knobs, IN, CCN C51107 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Nov 27, 2023

Owned or controlled facilities with NPI records 12

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1043010077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 SPRING ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303452",
            "telephone_number": "812-280-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 E COURT AVE",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303414",
            "telephone_number": "812-280-2080",
            "fax_number": "812-206-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPRING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "SWOBODA",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "PRACTICE MANAGEMENT DIRECTOR",
        "authorized_official_telephone_number": "812-206-1249"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeSpring Forensics Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.