NPIMap

Organization Active NPI

Lifespring Community Health

  • Pediatrics Physician
  • Chattanooga, TN
National Provider Identifier
1699079673
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
26074 Issued in TN
Legal business name
LIFESPRING COMMUNITY HEALTH
Practice address
2507 McCallie Ave
Chattanooga, TN 37404-3304
Phone
(423) 624-4846
Fax
(423) 624-4847
NPI assigned
Jan 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Dr. Michele Albury Pickett, M.D.NPI 1558588111
Title
Executive Director
Phone
(423) 304-4525

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 26074 TN Primary

Addresses

Primary practice location

2507 McCallie Ave
Chattanooga, TN 37404-3304

Mailing address

2507 McCallie Ave
Chattanooga, TN 37404-3304
Phone (423) 624-4846

Other identifiers 3

IdentifierTypeStateIssuer
000643706AMedicaidGA
1514642MedicaidTN
1526288MedicaidTN

National Provider Directory

National Provider Directory

Locations

1042 E 3rd St
Ste 200
Chattanooga, TN 37403
Phone (423) 624-4846

Practitioners & affiliated clinicians

Practitioners 12

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": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1699079673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043304",
            "telephone_number": "423-624-4846",
            "fax_number": "423-624-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043304",
            "telephone_number": "423-624-4846",
            "fax_number": "423-624-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPRING COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "PICKETT",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "ALBURY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "423-304-4525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "26074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000643706A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1514642",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1526288",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.