Organization Active NPI

Lifetime Medical Associates, P.C.

  • Adolescent Medicine (Internal Medicine) Physician
  • Rochester Hills, MI
National Provider Identifier
1174544050
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
Legal business name
LIFETIME MEDICAL ASSOCIATES, P.C.
Practice address
1701 South Blvd E Ste 250
Rochester Hills, MI 48307-6123
Phone
(248) 293-1002
Fax
(248) 293-1272
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Mrs. Melissa Mead
Title
Billing
Phone
(248) 293-1002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RA0000X MI Primary

Addresses

Primary practice location

1701 South Blvd E Ste 250
Rochester Hills, MI 48307-6123

Mailing address

1701 South Blvd E Ste 250
Rochester Hills, MI 48307-6123
Phone (248) 293-1002

Other identifiers 1

IdentifierTypeStateIssuer
3522770MedicaidMI

National Provider Directory

National Provider Directory

Locations

1701 South Blvd E
Ste 250
Rochester Hills, MI 48307
Phone (248) 293-1002

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1174544050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E STE 250",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076123",
            "telephone_number": "248-293-1002",
            "fax_number": "248-293-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E STE 250",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076123",
            "telephone_number": "248-293-1002",
            "fax_number": "248-293-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "MEAD",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "248-293-1002",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3522770",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.