NPIMap

Organization Active NPI

Lifeline

  • Community/Behavioral Health Agency
  • Cookeville, TN
National Provider Identifier
1619112323
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
I000000003680 Issued in TN
Legal business name
LIFELINE
Practice address
599 Vickers PL Ste D
Cookeville, TN 38501-4076
Phone
(931) 525-6773
NPI assigned
Dec 9, 2008
Organization subpart
Yes
Parent organization
LIFECARE FAMILY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Authorized official

Name
Landon Kent Mauck, BBA
Title
HR Coordinator
Phone
(615) 781-0013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X I000000003680 TN Primary

Addresses

Primary practice location

599 Vickers PL Ste D
Cookeville, TN 38501-4076

Mailing address

599 Vickers PL Ste D
Cookeville, TN 38501-4076
Phone (931) 525-6773

Other identifiers 1

IdentifierTypeStateIssuer
3376955OtherTNGROUP MEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Lifecare Family Services8 organizations share this tax ID, including this one
Part of
Lifecare Family Services

Other organizations with this tax ID 7

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

Locations

599 Vickers Pl
Ste D
Cookeville, TN 38501
Phone (931) 525-6773

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1619112323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 VICKERS PL STE D",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014076",
            "telephone_number": "931-525-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 VICKERS PL STE D",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014076",
            "telephone_number": "931-525-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFECARE FAMILY SERVICES",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "MAUCK",
        "authorized_official_first_name": "LANDON",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "HR COORDINATOR",
        "authorized_official_telephone_number": "615-781-0013",
        "authorized_official_credential": "BBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TN",
            "license": "I000000003680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "3376955",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.