Organization Active NPI

Life Health and Wellness Medical Center LLC

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1639037534
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFE HEALTH AND WELLNESS MEDICAL CENTER LLC
Practice address
403 Parker Ivey Dr
Greenville, SC 29607-6513
Phone
(864) 720-3390
Fax
(864) 288-6818
NPI assigned
Jan 12, 2026
Last updated
Jan 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
Yvette Erica Edwards, DCNPI 1912077173
Title
Owner
Phone
(864) 720-3390

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

403 Parker Ivey Dr
Greenville, SC 29607-6513

Mailing address

403 Parker Ivey Dr
Greenville, SC 29607-6513
Phone (864) 720-3390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260306000954 SC Part B Supplier - Clinic/Group Practice 8628550746 Practice locations: Greenville, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1768176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1639037534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 PARKER IVEY DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076513",
            "telephone_number": "864-720-3390",
            "fax_number": "864-288-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 PARKER IVEY DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076513",
            "telephone_number": "864-720-3390",
            "fax_number": "864-288-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE HEALTH AND WELLNESS MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_middle_name": "ERICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-720-3390",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.