Organization Active NPI

Lifecycle Primary Healthcare Center PC

Doing business as Lifecycle Healthcare

  • Internal Medicine Physician
  • Douglasville, GA
National Provider Identifier
1497494314
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIFECYCLE PRIMARY HEALTHCARE CENTER PC
Doing business as
Lifecycle Healthcare
Practice address
6853 Douglas Blvd Ste C
Douglasville, GA 30135-7179
Phone
(678) 266-7150
Fax
(678) 336-1694
NPI assigned
May 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Authorized official

Name
Dr. Debbie R Brewer, MDNPI 1215209275
Title
Medical Director
Phone
(678) 266-7150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

6853 Douglas Blvd Ste C
Douglasville, GA 30135-7179

Mailing address

4529 Cabinwood Turn
Douglasville, GA 30135-1959
Phone (404) 587-6038

Other names 1

  • Lifecycle Healthcare Doing business as

National Provider Directory

National Provider Directory

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": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653955200000",
    "number": "1497494314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4529 CABINWOOD TURN",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351959",
            "telephone_number": "404-587-6038",
            "fax_number": "678-336-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6853 DOUGLAS BLVD STE C",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357179",
            "telephone_number": "678-266-7150",
            "fax_number": "678-336-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECYCLE PRIMARY HEALTHCARE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "678-266-7150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifecycle Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.