Lifetime Medical Care PLLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

AP7289 Issued in AZ

Legal business name

LIFETIME MEDICAL CARE PLLC

Practice address

3101 Clearwater Dr
Suite B
Prescott, AZ 86305-7180

Phone

(928) 237-9014

Fax

(928) 237-9063

NPI assigned

Jul 24, 2014

Last updated

Jan 4, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shelly Damschroder, FNP

Title

Manager/Owner/Provider

Phone

(928) 237-9014

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17540/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420329600000",
    "number": "1265840037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 CLEARWATER DR",
            "address_2": "SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057180",
            "telephone_number": "928-237-9014",
            "fax_number": "928-237-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 CLEARWATER DR",
            "address_2": "SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057180",
            "telephone_number": "928-237-9014",
            "fax_number": "928-237-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME MEDICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2015-01-04",
        "status": "A",
        "authorized_official_last_name": "DAMSCHRODER",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "MANAGER/OWNER/PROVIDER",
        "authorized_official_telephone_number": "928-237-9014",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "AZ",
            "license": "AP7289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE NUMBER",
            "identifier": "AP7289",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rural Health Clinic/Center in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Rural Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2015; 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.