Lifespan, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

001614-1 Issued in IN

Legal business name

LIFESPAN, INC.

Practice address

800 Bell Trace Cir
Bloomington, IN 47408-4405

Phone

(812) 335-2445

Fax

(812) 353-7576

NPI assigned

Mar 23, 2006

Last updated

Aug 22, 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

Dr. Stephen G. Moore, MDNPI 1073815882

Title

President/Ceo

Phone

(812) 332-2265

Specialties & licenses 1

Addresses

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.

• Stephen G Moore, M.D.

  • Specialist
  • Bloomington, IN
  • NPI 1073815882
  Authorized official Same address or phone

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427018639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3749 E. COVENANTER DRIVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015454",
            "telephone_number": "812-332-2265",
            "fax_number": "812-334-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BELL TRACE CIR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474084405",
            "telephone_number": "812-335-2445",
            "fax_number": "812-353-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "812-332-2265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "001614-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.