NPIMap

Organization Active NPI

Lifespan Incorporated

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1144717018
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIFESPAN INCORPORATED
Practice address
3529 Hatwynn Rd
Charlotte, NC 28269-1329
Phone
(704) 944-5100
NPI assigned
Apr 17, 2018
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Robin Devore
Title
VP Corporate Compliance and Operati
Phone
(704) 944-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

3529 Hatwynn Rd
Charlotte, NC 28269-1329

Mailing address

1511 Shopton Rd Ste a
Charlotte, NC 28217-3240
Phone (704) 763-1887

Other practice location 1

4322 Fairview Rd Ste A
Andrews, NC 28901-8114
Phone (704) 944-5100

Other practice location 2

264 Lillie Ln Ste A
Canton, NC 28716-7900
Phone (704) 944-5100

Other practice location 3

944 Nc Highway 141 Ste A
Murphy, NC 28906-6878
Phone (704) 944-5100

Other practice location 4

78 Market St Ste A
Maggie Valley, NC 28751-8594
Phone (704) 944-5100

Other identifiers 1

IdentifierTypeStateIssuer
348802MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Lifespan Inc58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1144717018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 SHOPTON RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173240",
            "telephone_number": "704-763-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3529 HATWYNN RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691329",
            "telephone_number": "704-944-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4322 Fairview Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Andrews",
            "state": "NC",
            "postal_code": "289018114",
            "country_code": "US",
            "telephone_number": "704-944-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "264 Lillie Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "NC",
            "postal_code": "287167900",
            "country_code": "US",
            "telephone_number": "704-944-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "944 Nc Highway 141 Ste A",
            "address_purpose": "LOCATION",
            "city": "Murphy",
            "state": "NC",
            "postal_code": "289066878",
            "country_code": "US",
            "telephone_number": "704-944-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "78 Market St Ste A",
            "address_purpose": "LOCATION",
            "city": "Maggie Valley",
            "state": "NC",
            "postal_code": "287518594",
            "country_code": "US",
            "telephone_number": "704-944-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFESPAN INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "DEVORE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "VP CORPORATE COMPLIANCE AND OPERATI",
        "authorized_official_telephone_number": "704-944-5100"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348802",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.