Lifetime Women'S Health & Fitness Centers P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101240033 Issued in VA

Legal business name

LIFETIME WOMEN'S HEALTH & FITNESS CENTERS P.C.

Practice address

1037 Champions Way
Suite 300
Suffolk, VA 23435-3764

Phone

(757) 395-7414

Fax

(757) 923-4607

NPI assigned

Oct 24, 2012

Organization subpart

No

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

Authorized official

Name

Edward Ellison Wing, MDNPI 1598792525

Title

President

Phone

(757) 395-7414

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Edward Ellison Wing, M.D.

  • Obstetrics & Gynecology Physician
  • Suffolk, VA
  • NPI 1598792525

  Specialist

  Medicare reassignment Care Compare group NPD Authorized official
• Alisha Quentell Dunn

  • Women's Health Nurse Practitioner
  • Suffolk, VA
  • NPI 1609523653
  Medicare reassignment Care Compare group NPD
• Chelsie Lynn Mulholland, PA

  • Physician Assistant
  • Saint Louis, MO
  • NPI 1912400425
  NPD (past)

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1093068371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 BRIDGE RD",
            "address_2": "SUITE 8 PMB 433",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351800",
            "telephone_number": "757-395-7414",
            "fax_number": "757-923-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 CHAMPIONS WAY",
            "address_2": "SUITE 300",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353764",
            "telephone_number": "757-395-7414",
            "fax_number": "757-923-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME WOMEN'S HEALTH & FITNESS CENTERS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "WING",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "ELLISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-395-7414",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101240033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francheskaa Lewis, RN
• Kiara Marie Lewis
• Quintin S. Lewis, PT, DPT, CMTPT
• Shemeka Lewis
• Life'S at Home Care LLC
• Lillie'S Haven LLC
• Makiea R Linde, MA-RESIDENT IN COUNS
• Heather Carrico Lindsay, NP
• Cristin Linebach, SLP
• Danielle Liner, COTA

• Specialist in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.