Lifeline Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LIFELINE MEDICAL CENTER

Practice address

2101 Jackson St Ste 109
Anderson, IN 46016-4386

Phone

(814) 408-0014

NPI assigned

Aug 15, 2022

Organization subpart

No

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

• Elliana Brooks, MSW, LCSW

  • Clinical Social Worker
  • Anderson, IN
  • NPI 1033804471

  IN

  Medicare reassignment Care Compare group NPD
• Susan Castro, LSW

  • Social Worker
  • New Albany, IN
  • NPI 1952112112

  IN

  Medicare reassignment Care Compare group NPD
• Joyce Audrey Fields

  • Social Worker
  • Jeffersonville, IN
  • NPI 1124761101

  IN

  Medicare reassignment Care Compare group NPD
• Kourtney Marie Gallegos, MSW

  • Clinical Social Worker
  • Muncie, IN
  • NPI 1831644319

  IN

  Medicare reassignment Care Compare group NPD
• Terry Alicia Little, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Muncie, IN
  • NPI 1215025481

  Family, IN, OR

  Medicare reassignment Care Compare group NPD
• Hannah Small, LCSW

  • Clinical Social Worker
  • Muncie, IN
  • NPI 1881367282

  IN

  Medicare reassignment Care Compare group NPD
• Natalie Michelle Stone, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • New Albany, IN
  • NPI 1588376396

  IN, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Douglas Lee Watson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • New Albany, IN
  • NPI 1770211658

  IN, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Jessica Bentura Jimenez, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
  • NPI 1285392126

  OR, Psychiatric/Mental Health, WA

  Medicare reassignment Care Compare group NPD
• Sahara Bunna, LPC

  • Professional Counselor
  • Decatur, TX
  • NPI 1407544406

  OR, Professional, TX

  Medicare reassignment Care Compare group NPD
• Clarisse Michelle Carter

  • Primary Care Nurse Practitioner
  • Southfield, MI
  • NPI 1932247889

  Family, MI

  Medicare reassignment Care Compare group NPD
• Lakeetra A. Catchings, MA, LCPC, LPC, ACS

  • Professional Counselor
  • Maynard, MA
  • NPI 1558664219

  IL, Mental Health, OR

  Medicare reassignment Care Compare group NPD

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

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in OR, MI, IN, PA, TX, ID, WA, CA, NM, IL, AR, GA, FL13 enrollments

Enrollment records 13

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4

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

Authorized official

Name

Patricia Griesheimer

Title

Coo

Phone

(814) 243-0414

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 2

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1265160451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3159 CARPENTERS PARK RD",
            "city": "DAVIDSVILLE",
            "state": "PA",
            "postal_code": "159289223",
            "telephone_number": "814-408-0014",
            "fax_number": "814-479-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 JACKSON ST STE 109",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164386",
            "telephone_number": "814-408-0014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Galleria Dr",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159048906",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35200 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483104837",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23077 Greenfield Rd Ste 455",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480753740",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1415 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Oak Brook",
            "state": "IL",
            "postal_code": "605232074",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6565 Americas Pkwy NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871108172",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3415 S Sepulveda Blvd Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900347090",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1915 NE Stucki Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "970066938",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 NE 136th Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986846937",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 Westfork Dr Ste 401",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708270004",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10121 SE Sunnyside Rd",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970155745",
            "country_code": "US",
            "telephone_number": "814-409-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3707 E Southern Ave Ste 1025",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852066202",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 University Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "PA",
            "postal_code": "189401873",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13509 Lyndon B Johnson Fwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750414704",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2245 Texas Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774791468",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10121 SE Sunnyside Rd",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970155745",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Town Ctr Ste 1900",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480751152",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "fax_number": "814-479-5906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 NW Bethany Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970065236",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "fax_number": "503-914-6422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2180 Satellite Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300974927",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8875 Hidden River Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336372087",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3597 E Monarch Sky Ln Ste 240",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836461055",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3415 S Sepulveda Blvd Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900347090",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "698 12th St SE Ste 240-5",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973014039",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1925 NE Stucki Ave",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "970066945",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "IN",
            "postal_code": "460164388",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Pacific Ave Ste 6",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984024393",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "321 Main St",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159011632",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2855 Charlestown Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471502691",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3159 Carpenters Park Rd",
            "address_purpose": "LOCATION",
            "city": "Davidsville",
            "state": "PA",
            "postal_code": "159289223",
            "country_code": "US",
            "telephone_number": "814-408-0014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFELINE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "GRIESHEIMER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "814-243-0414"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99999999999",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.lifelinemedicalcenter.org",
            "affiliation": "N",
            "endpointDescription": "www.lifelinemedicalcenter.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 NW Bethany Blvd Ste 200",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970065236",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.lifelinemedicalcenter.org",
            "affiliation": "N",
            "endpointDescription": "www.lifelinemedicalcenter.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2245 Texas Dr Ste 300",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774791468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason Lewis, MD
• Sarah Lewis
• Teonna Patrice Lewis
• Ching Li, M.D.
• Kevin Liebrum, CRNA
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• Austin-Ian Light
• Craig Alan Light, D.D.S.
• Addison Limbrock
• Yun Lin, PTA

• All providers in Anderson, IN
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.