Lifetime Healthchoice LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

LIFETIME HEALTHCHOICE LLC

Practice address

134 Evergreen PL Ste 705
East Orange, NJ 07018-2012

Phone

(973) 641-8836

Fax

(973) 695-3795

NPI assigned

Jul 10, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Dennis Yeboah Kordie, DNPNPI 1447640362

Title

Owner/Nurse Practitioner

Phone

(973) 641-8836

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Dennis Kordie

  • Family Nurse Practitioner
  • East Orange, NJ
  • NPI 1447640362
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1073009338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HAWTHORNE PL APT 4M",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423277",
            "telephone_number": "973-641-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 EVERGREEN PL STE 705",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182012",
            "telephone_number": "973-641-8836",
            "fax_number": "973-695-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME HEALTHCHOICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "KORDIE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "YEBOAH",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "973-641-8836",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Developmental Disabilities Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.