NPIMap

Organization Active NPI

Lifecare Supportive Medicine Incorporated

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Wilmington, NC
National Provider Identifier
1316804446
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
LIFECARE SUPPORTIVE MEDICINE INCORPORATED
Practice address
1414 Physicians Dr
Wilmington, NC 28401-7335
Phone
(910) 796-8000
Fax
(910) 796-8000
NPI assigned
Jan 9, 2026
Last updated
Jan 9, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
LOWER CAPE FEAR HOSPICE INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

Name
Timothy King
Title
Chief Operating Officer
Phone
(910) 796-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU Primary

Addresses

Primary practice location

1414 Physicians Dr
Wilmington, NC 28401-7335

Mailing address

1414 Physicians Dr
Wilmington, NC 28401-7335
Phone (910) 796-8000

Other practice location 1

1314 3rd Ave
Conway, SC 29526-5002
Phone (843) 848-6480

Other practice location 2

2250 Shipyard Blvd
Wilmington, NC 28403-8024
Phone (910) 796-8000

Other identifiers 2

IdentifierTypeStateIssuer
89012N8MedicaidNC
HSP148MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260519000709 NC Part B Supplier - Clinic/Group Practice 5092284182 Receives reassigned benefits from 30 practitioners
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory
Tax ID family
Lifecare Supportive Medicine Incorporated2 organizations share this tax ID, including this one
Part of
Lower Cape Fear Hospice Incorporated

Other organizations with this tax ID 1

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

Locations

1314 3rd Ave
Conway, SC 29526
Phone (843) 848-6480

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1767916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1316804446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 PHYSICIANS DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017335",
            "telephone_number": "910-796-8000",
            "fax_number": "910-796-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 PHYSICIANS DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017335",
            "telephone_number": "910-796-8000",
            "fax_number": "910-796-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1314 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295265002",
            "country_code": "US",
            "telephone_number": "843-848-6480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2250 Shipyard Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284038024",
            "country_code": "US",
            "telephone_number": "910-796-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFECARE SUPPORTIVE MEDICINE INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOWER CAPE FEAR HOSPICE INCORPORATED",
        "enumeration_date": "2026-01-09",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "910-796-8000"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012N8",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP148",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.