Lifeplex Medical Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01024911A Issued in IN

Legal business name

LIFEPLEX MEDICAL INC

Doing business as

LifePlex Family Practice

Practice address

2855 Miller Dr Ste 117
Plymouth, IN 46563-8091

Phone

(574) 936-7777

Fax

(574) 941-1072

NPI assigned

Jul 11, 2017

Organization subpart

No

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

Authorized official

Name

Byron Holm, MD

Title

MD

Phone

(574) 936-7777

Specialties & licenses 2

Addresses

Other names 1

• LifePlex Family Practice Doing business as

Electronic endpoints 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

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1114449238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 MILLER DR STE 117",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465638091",
            "telephone_number": "574-936-7777",
            "fax_number": "574-941-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 MILLER DR STE 117",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465638091",
            "telephone_number": "574-936-7777",
            "fax_number": "574-941-1072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Michigan St",
            "address_purpose": "LOCATION",
            "city": "Walkerton",
            "state": "IN",
            "postal_code": "465741116",
            "country_code": "US",
            "telephone_number": "574-936-7777",
            "fax_number": "574-941-1072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2855 Miller Dr Ste 119",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "IN",
            "postal_code": "465638091",
            "country_code": "US",
            "telephone_number": "574-941-1000",
            "fax_number": "574-941-1075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFEPLEX MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-11",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "BYRON",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "574-936-7777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01024911A",
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "holm.jones@lpm.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2855 Miller Dr Ste 117",
            "city": "Plymouth",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465638091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "LifePlex Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Lee
• Mason Leed
• Maria Leon
• Stephanie Lewis, OTR
• Lifeplex Diagnostic Center, L.L.C.
• Lifeplex Urgent Care, L.L.C.
• Lighthouse Dental
• Louis Plumlee DDS
• Lynn Ann Lucas, LCSW
• Kristine Luna, MA

• Family Medicine Physician in Plymouth, IN
• Providers in Plymouth, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.