NPIMap

Organization Active NPI

Life Cycle OB/GYN, LLC

  • Obstetrics & Gynecology Physician
  • Decatur, GA
National Provider Identifier
1457866535
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LIFE CYCLE OB/GYN, LLC
Practice address
428 Winn CT
Decatur, GA 30030-1726
Phone
(404) 766-8371
NPI assigned
Dec 11, 2017
Last updated
Dec 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Authorized official

Name
Anne Sirey SigouinNPI 1346358777
Title
Practice Manager
Phone
(404) 405-4543

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

428 Winn CT
Decatur, GA 30030-1726

Mailing address

2739 Felton Dr
East Point, GA 30344-3603
Phone (404) 766-8371

Other identifiers 1

IdentifierTypeStateIssuer
300035567EMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Life Cycle OBGYN LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

428 Winn Ct
Decatur, GA 30030
Phone (404) 292-3727

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1457866535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2739 FELTON DR",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443603",
            "telephone_number": "404-766-8371",
            "fax_number": "404-767-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 WINN CT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301726",
            "telephone_number": "404-766-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CYCLE OB/GYN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "SIGOUIN",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "SIREY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "404-405-4543"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300035567E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.

Verify at the official NPI Registry.