NPIMap

Organization Active NPI

Life Medical Center, Inc.

  • Family Medicine Physician
  • Troy, OH
National Provider Identifier
1083799357
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35067724 Issued in OH
Legal business name
LIFE MEDICAL CENTER, INC.
Practice address
80 Troy Town Dr
Troy, OH 45373-2328
Phone
(937) 681-5740
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Mrs. Julie Renee Grawe
Title
Billing Specialist
Phone
(937) 681-5740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 35067724 OH Primary

Addresses

Primary practice location

80 Troy Town Dr
Troy, OH 45373-2328

Mailing address

PO Box 4428
Sidney, OH 45365-4428

Other identifiers 1

IdentifierTypeStateIssuer
2563757MedicaidOH

National Provider Directory

National Provider Directory

Locations

80 Troy Town Dr
Troy, OH 45373
Phone (937) 440-1600

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1083799357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4428",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453654428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 TROY TOWN DR",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453732328",
            "telephone_number": "937-681-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "GRAWE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "937-681-5740",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35067724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2563757",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.