Active NPI
Lifeboat Medical Associates 2, LLC
- Gynecology Physician
- Peachtree City, GA
National Provider Identifier
1346756129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- Legal business name
- LIFEBOAT MEDICAL ASSOCIATES 2, LLC
- Practice address
- 1201 Georgian Park
Peachtree City, GA 30269-6972 - Phone
- (770) 631-4873
- Fax
- (770) 631-0684
- NPI assigned
- Dec 15, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Shelley Depp
- Title
- Payer Relations Liaison
- Phone
- (770) 579-2626
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | Primary |
Addresses
Primary practice location
1201 Georgian Park
Peachtree City, GA 30269-6972
Mailing address
PO Box 468329
Atlanta, GA 31146-8329
Phone (404) 943-0205
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513296000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1513296000000",
"number": "1346756129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 468329",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311468329",
"telephone_number": "404-943-0205",
"fax_number": "404-943-0209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 GEORGIAN PARK",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302696972",
"telephone_number": "770-631-4873",
"fax_number": "770-631-0684"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFEBOAT MEDICAL ASSOCIATES 2, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-12-15",
"last_updated": "2017-12-15",
"status": "A",
"authorized_official_last_name": "DEPP",
"authorized_official_first_name": "SHELLEY",
"authorized_official_title_or_position": "PAYER RELATIONS LIAISON",
"authorized_official_telephone_number": "770-579-2626",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peachtree City, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.