Lifewise Physical Medicine Center, LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

0104001882 Issued in VA

Legal business name

LIFEWISE PHYSICAL MEDICINE CENTER, LLC

Practice address

4633 Brambleton Ave
Roanoke, VA 24018-3410

Phone

(540) 400-7733

Fax

(540) 904-6009

NPI assigned

Mar 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Rhett Travis, D.C.

Title

Owner

Phone

(540) 400-7733

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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

• Che Monte Torry, DO

  • Interventional Pain Medicine Physician
  • Newport News, VA
  • NPI 1326402116
  NPD (past)

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1689844524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4633 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183410",
            "telephone_number": "540-400-7733",
            "fax_number": "540-904-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4633 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183410",
            "telephone_number": "540-400-7733",
            "fax_number": "540-904-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWISE PHYSICAL MEDICINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "TRAVIS",
        "authorized_official_first_name": "RHETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-400-7733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "VA",
            "license": "0104001882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "346267",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "346268",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1508935362",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Valerie Liebesny, MD
• Kristin Anne Liebrecht, M.D.
• Life Solutions LLC
• Life Worth Living Counseling, LTD.
• Lifeforce Counseling and Consulting, LLC
• Lifeworks Services, LLC
• Ashley Light, AU.D.
• James Light, MD
• Sariah E Light, D.D.S.
• Like Family Healthcare LLC

• Rehabilitation Chiropractor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Rehabilitation Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.