Life IV Therapy PLLC

Primary specialty

Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X

Legal business name

LIFE IV THERAPY PLLC

Practice address

5433 S Occidental Rd Ste C
Tecumseh, MI 49286-9782

Phone

(517) 273-3210

Fax

(734) 418-9068

NPI assigned

Oct 2, 2024

Organization subpart

No

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

Authorized official

Name

Justin Henry, RNNPI 1275335358

Title

Ceo

Phone

(517) 273-3210

Specialties & licenses 1

Addresses

Other names 1

• Life IV Weight Loss Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 8

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

• Eowyn Elise Boyd, NP

  • Primary Care Nurse Practitioner
  • Adrian, MI
  • NPI 1356937379
  Medicare reassignment Care Compare group NPD
• Victor Joseph Cherfan Jr., D.O.

  • Obstetrics & Gynecology Physician
  • Adrian, MI
  • NPI 1841419421
  Medicare reassignment Care Compare group NPD
• Kathryn Mari Castorena, NP

  • Nurse Practitioner
  • Ann Arbor, MI
  • NPI 1659793420
  Medicare reassignment NPD
• Justin Robert Henry, RN

  • Registered Nurse
  • Tecumseh, MI
  • NPI 1275335358
  NPD Authorized official
• Abbey L Brown, FNP-BC

  • Family Nurse Practitioner
  • Tecumseh, MI
  • NPI 1538975198
  Medicare reassignment
• Jasmina Mesic

  • Registered Dietitian
  • Chicago, IL
  • NPI 1730940156

  MI

  Medicare reassignment
• Peggy Joan Molter, MA LPC

  • Counselor
  • Adrian, MI
  • NPI 1275167009
  NPD
• Kelli Ann Watkins, LMSW

  • Clinical Social Worker
  • Adrian, MI
  • NPI 1245510601
  NPD (past)

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1396563821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5433 S OCCIDENTAL RD STE C",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492869782",
            "telephone_number": "517-273-3210",
            "fax_number": "734-418-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5433 S OCCIDENTAL RD STE C",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492869782",
            "telephone_number": "517-273-3210",
            "fax_number": "734-418-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE IV THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-02",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "517-273-3210",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life IV Weight Loss",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Life IV Weight Loss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaylen Lambka
• Andrea Lauderdale, DPT
• Robert Leffler, PT
• Shaun Lewandowski
• Kun Li, M.D.
• Marybeth Lips
• Lisa Livingston, LLPC
• Jamie Jeanine Lloyd
• Lomonaco Healthcare LLC
• Julie Noelle Lomonaco, D.C.

• Obesity Medicine (Internal Medicine) Physician in Tecumseh, MI
• Providers in Tecumseh, MI by specialty
• Obesity Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.