Lifestyle Pain Management and Wellness Center, PC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

LIFESTYLE PAIN MANAGEMENT AND WELLNESS CENTER, PC

Practice address

1982 Main St E Ste C
Snellville, GA 30078-6461

Phone

(470) 395-3618

Fax

(770) 979-5155

NPI assigned

Jun 19, 2020

Last updated

Jun 19, 2020By 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

Belinda Millington, MDNPI 1255596458

Title

Ceo

Phone

(470) 395-3618

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• Belinda Millington, MD

  • General Practice Physician
  • Snellville, GA
  • NPI 1255596458
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1417573114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1982 MAIN ST E STE C",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786461",
            "telephone_number": "470-395-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1982 MAIN ST E STE C",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786461",
            "telephone_number": "470-395-3618",
            "fax_number": "770-979-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE PAIN MANAGEMENT AND WELLNESS CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "MILLINGTON",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "470-395-3618",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "66224",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "office@minormedicalhealthcare.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1982 Main St E Ste C",
            "city": "Snellville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300786461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pain Clinic/Center in Snellville, GA
• Providers in Snellville, GA by specialty
• Pain Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.