NPIMap

Organization Active NPI

Life Essential Resources

  • Clinical Medical Laboratory
  • Conyers, GA
National Provider Identifier
1083293070
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LIFE ESSENTIAL RESOURCES
Practice address
2115 Crest Wood Dr
Conyers, GA 30094-4786
Phone
(404) 452-8648
NPI assigned
Apr 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Chadeesia Dunkley, RNNPI 1730767120
Title
Ceo
Phone
(404) 452-8648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2115 Crest Wood Dr
Conyers, GA 30094-4786

Mailing address

2115 Crest Wood Dr
Conyers, GA 30094-4786
Phone (404) 452-8648

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": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1083293070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 CREST WOOD DR",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300944786",
            "telephone_number": "404-452-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 CREST WOOD DR",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300944786",
            "telephone_number": "404-452-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ESSENTIAL RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "DUNKLEY",
        "authorized_official_first_name": "CHADEESIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-452-8648",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.