Living Well Primary Care, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LIVING WELL PRIMARY CARE, LLC

Practice address

101 Devant St
Suite 902
Fayetteville, GA 30214-2710

Phone

(770) 716-8228

Fax

(770) 716-6588

NPI assigned

Feb 22, 2012

Organization subpart

No

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

Authorized official

Name

Michelle Jones

Title

Practice Administrator

Phone

(803) 807-9533

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kelvin D. White, M.D.

  • Family Medicine Physician
  • Fayetteville, GA
  • NPI 1457336935
  NPD (past)

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1144593021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DEVANT ST",
            "address_2": "SUITE 902",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142710",
            "telephone_number": "770-716-8228",
            "fax_number": "770-716-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DEVANT ST",
            "address_2": "SUITE 902",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142710",
            "telephone_number": "770-716-8228",
            "fax_number": "770-716-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "803-807-9533"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Taylor Lisicia, OTR/L
• Little Walkers ABA LLC
• Liyun Liu, MD
• Yi-Ping Liu, D.D.S.
• Living Private Home Care, LLC
• Kyre Lochan
• Vipin Ramprasad Lohiya, M.D.
• Angela Long
• Brian D Long, MD
• Christine Long, M.D

• Family Medicine Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.