Organization Active NPI

Life Management International Inc.

  • Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1083793046
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP1921112 Issued in FL
Legal business name
LIFE MANAGEMENT INTERNATIONAL INC.
Practice address
1267 Timberidge Loop N
Lakeland, FL 33809-4682
Phone
(863) 602-7908
Fax
(863) 815-1901
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Authorized official

Name
Pius N. Godwin, ARNPNPI 1831187012
Title
Co-Owner
Phone
(863) 602-7908

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X ARNP1921112 FL Primary

Addresses

Primary practice location

1267 Timberidge Loop N
Lakeland, FL 33809-4682

Mailing address

1267 Timberidge Loop N
Lakeland, FL 33809-4682
Phone (863) 602-7908

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819000878 FL Part B Supplier - Clinic/Group Practice 8820061500 Receives reassigned benefits from 1 practitioner
Practice locations: Brandon, FL; Valrico, FL; Tampa, FL; Plant City, FL; Lakeland, FL; Dover, FL

National Provider Directory

National Provider Directory

Locations

605 Carpenters Way
Lakeland, FL 33809
Phone (863) 226-4082

6929 Durant Rd
Plant City, FL 33567
Phone (813) 737-1736

Practitioners & affiliated clinicians

Practitioners 3

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": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1083793046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1267 TIMBERIDGE LOOP N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338094682",
            "telephone_number": "863-602-7908",
            "fax_number": "863-815-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 TIMBERIDGE LOOP N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338094682",
            "telephone_number": "863-602-7908",
            "fax_number": "863-815-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE MANAGEMENT INTERNATIONAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "PIUS",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "863-602-7908",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1921112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.