NPIMap

Organization Active NPI

Life Cycle OBGYN, LLC

  • Obstetrics Physician
  • East Point, GA
National Provider Identifier
1467664276
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
053504 Issued in GA
Legal business name
LIFE CYCLE OBGYN, LLC
Practice address
2739 Felton Dr
East Point, GA 30344-3603
Phone
(404) 766-8371
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Anne SigouinNPI 1346358777
Title
Practice Manager
Phone
(404) 766-8371

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0000X 053504 GA Primary

Addresses

Primary practice location

2739 Felton Dr
East Point, GA 30344-3603

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
235663182AMedicaidGA
00894396AMedicaidGA
547811054AMedicaidGA

National Provider Directory

National Provider Directory

Locations

428 Winn Ct
Ste 100
Decatur, GA 30030

428 Winn Ct
Ste 100AB
Decatur, GA 30030
Phone (404) 228-0601

1100 Cleveland Ave
Bldg 1100
East Point, GA 30344
Phone (404) 766-8371

Practitioners & affiliated clinicians

Practitioners 2

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": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1467664276",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2739 FELTON DR",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443603",
            "telephone_number": "404-766-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CYCLE OBGYN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "SIGOUIN",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "404-766-8371"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "GA",
            "license": "053504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235663182A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00894396A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "547811054A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.