Lifelong Wellness Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LIFELONG WELLNESS CENTER INC

Practice address

1203 E Ross Byp Ste C
Tahlequah, OK 74464-4188

Phone

(918) 458-0700

Fax

(918) 458-0424

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Edith-Elaine Hamill Hodson

Title

President

Phone

(918) 453-8550

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Brian Shawn Bobb, M.D.

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1144280991
  NPD (past)

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1043413487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 E ROSS BYPASS",
            "address_2": "C",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644188",
            "telephone_number": "918-453-8550",
            "fax_number": "918-456-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 E ROSS BYP STE C",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644188",
            "telephone_number": "918-458-0700",
            "fax_number": "918-458-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "HODSON",
        "authorized_official_first_name": "EDITH-ELAINE",
        "authorized_official_middle_name": "HAMILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-453-8550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Sue Lewis, COTA/L
• Rebecca C Lewis, D.O.
• Shelby Lewis, PHARM.D.
• Sierra Lewis
• Chad Lewman
• Jenna Marie Lighthizer, O.D.
• Nathan Robert Lighthizer, O.D.
• Lisa Ann Lillard
• Limb Salvage International
• Limb Salvage International

• Family Medicine Physician in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.