Active NPI
Lifesource Accountability Inc
- Family Medicine Physician
- Clinton, SC
National Provider Identifier
1417867417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- LIFESOURCE ACCOUNTABILITY INC
- Practice address
- 939 Springdale Dr
Clinton, SC 29325-7266 - Phone
- (910) 742-9243
- Fax
- (888) 746-1787
- NPI assigned
- Sep 10, 2026
- 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
- Eryn M Robbins
- Title
- Vice President of Operations
- Phone
- (910) 622-2319
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| General Practice Physician | 208D00000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X | |||
| Family Nurse Practitioner | 363LF0000X | |||
| Primary Care Nurse Practitioner | 363LP2300X |
Addresses
Primary practice location
939 Springdale Dr
Clinton, SC 29325-7266
Mailing address
3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone (910) 742-9243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788998400000",
"number": "1417867417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3205 RANDALL PKWY STE 105",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284032565",
"telephone_number": "910-742-9243",
"fax_number": "888-746-1787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 SPRINGDALE DR",
"city": "CLINTON",
"state": "SC",
"postal_code": "293257266",
"telephone_number": "910-742-9243",
"fax_number": "888-746-1787"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFESOURCE ACCOUNTABILITY INC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-10",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A",
"authorized_official_last_name": "ROBBINS",
"authorized_official_first_name": "ERYN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
"authorized_official_telephone_number": "910-622-2319"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clinton, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.