Urolife Clinic LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

UROLIFE CLINIC LLC

Practice address

256 SW Professional GLN
Lake City, FL 32025-1104

Phone

(386) 758-8937

NPI assigned

Nov 11, 2024

Last updated

Apr 10, 2025By 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

Sarah C Dumas

Title

Manager

Phone

(386) 758-8937

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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.

• Jennifer Lyn Bryan, DNP, APRN-C

  • Nurse Practitioner
  • Lake City, FL
  • NPI 1316581879
  Medicare reassignment NPD
• Mary Ratliff Kedrowski, D.O.

  • Surgery Physician
  • Lake City, FL
  • NPI 1629483508
  Medicare reassignment NPD

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1477377026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 SW PROFESSIONAL GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251104",
            "telephone_number": "386-758-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 SW PROFESSIONAL GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251104",
            "telephone_number": "386-758-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLIFE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "DUMAS",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "386-758-8937"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veneka Underwood
• Michelle Unterborn, RN
• Upperline Healthcare, PC
• Upperline Healthcare, PC
• Nancey Whitehill (Lynne) Upshaw, L.M.T.
• Urology Medical Inc. (Busch Urology)
• Richard German Valenzuela, M.D.
• Valli Jeanenne Van Meter, PHARMD
• Patricia Vance
• Heather Ann Thornton Vann, M.ED./ED.S.

• Urology Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.