NPIMap

Organization Active NPI

Lifebrite Hospital Group of Stokes, LLC

Doing business as LifeBrite Family Medical And Specialty of King

  • Critical Access Hospital
  • King, NC
National Provider Identifier
1295278174
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
LIFEBRITE HOSPITAL GROUP OF STOKES, LLC
Doing business as
LifeBrite Family Medical And Specialty of King
Practice address
167 Moore Rd
King, NC 27021-8770
Phone
(336) 985-2140
Fax
(336) 983-2172
NPI assigned
Nov 28, 2016
Last updated
Mar 22, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Authorized official

Name
Mr. Christian Fletcher
Title
Ceo
Phone
(336) 593-5311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

167 Moore Rd
King, NC 27021-8770

Mailing address

167 Moore Rd
King, NC 27021-8770
Phone (336) 985-2140

Other identifiers 2

IdentifierTypeStateIssuer
H0165OtherNCHOSPITAL LICENSURE
G557OtherNCMEDICARE PART B PTAN

Other names 1

  • LifeBrite Family Medical And Specialty of King Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170220001211 NC Part B Supplier - Clinic/Group Practice 8921380759 Receives reassigned benefits from 29 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: King, NC; Pine Hall, NC; Danbury, NC

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lifebrite Hospital Group of10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1295278174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 MOORE RD",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218770",
            "telephone_number": "336-985-2140",
            "fax_number": "336-983-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MOORE RD",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218770",
            "telephone_number": "336-985-2140",
            "fax_number": "336-983-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRITE HOSPITAL GROUP OF STOKES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-593-5311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL LICENSURE",
            "identifier": "H0165",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B PTAN",
            "identifier": "G557",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBrite Family Medical And Specialty of King",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in King, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.