Active NPI
Lifespring, Inc
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- LIFESPRING, INC
- Practice address
- 460 Spring St
Jeffersonville, IN 47130-3452 - Phone
- (812) 280-2080
- NPI assigned
- Sep 10, 2019
- Last updated
- Sep 10, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Terry Stawar
- Title
- Ceo
- Phone
- (812) 206-1234
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
460 Spring St
Jeffersonville, IN 47130-3452
Mailing address
460 Spring St
Jeffersonville, IN 47130-3452
Phone (812) 280-2080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040315000128 | IN | Part B Supplier - Clinic/Group Practice | 5294624508 |
Receives reassigned benefits from 66 practitioners 16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: New Albany, IN; Paoli, IN; Rockport, IN; Salem, IN; Scottsburg, IN; Tell City, IN; Jeffersonville, IN; Madison, IN… |
| O20040805000332 | IN | Part B Supplier - Clinic/Group Practice | 5294624508 |
Receives reassigned benefits from 115 practitioners 19 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Dale, IN; Tell City, IN; Scottsburg, IN; Salem, IN; Rockport, IN; Paoli, IN; New Albany, IN; Madison, IN… |
| O20190918002103 | IN | Part A Provider - Federally Qualified Health Center (FQHC) | 5294624508 | Practice locations: Jeffersonville, IN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1700435948. Details of each certification follow.
Federally qualified health center certification: CCN 151058
- Legal name
- LIFESPRING, INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 18, 2019
- Last certification
- Sep 18, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Enrollment address
- 460 Spring St
Jeffersonville, IN 47130-3452
Other NPIs with the same Medicare PAC ID 15
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
5294624508
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
5294624508
-
dba New Albany Community Medical Services
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1750056461
5294624508
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
5294624508
-
dba Salem Community Schools Health Center
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1255006961
5294624508
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
5294624508
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
5294624508
-
dba LifeSpring Orleans Family Health
- Federally Qualified Health Center (FQHC)
- Orleans, IN
- NPI 1265277883
5294624508
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
5294624508
-
dba Metro Mobile Unit
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1619698669
5294624508
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1811512239
5294624508
-
dba Southern Indiana Mental Health and Guidance Center of ECI
- Community/Behavioral Health Agency
- Jeffersonville, IN
- NPI 1851489942
5294624508
Other NPIs on the same Medicare enrollment 19
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
O20040315000128, O20040805000332
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
O20040315000128, O20040805000332
-
dba New Albany Community Medical Services
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1750056461
O20040315000128, O20040805000332
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1851751887
O20040315000128, O20040805000332
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
O20040315000128, O20040805000332
-
dba Salem Community Schools Health Center
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1255006961
O20040315000128, O20040805000332
-
- Community/Behavioral Health Agency
- English, IN
- NPI 1104393206
O20040315000128, O20040805000332
-
dba Hope Center
- Substance Use Disorder Rehabilitation Clinic/Center
- Jasper, IN
- NPI 1164287595
O20040805000332
-
dba Charlestown Behavioral Services
- Community/Behavioral Health Agency
- Charlestown, IN
- NPI 1457186355
O20040805000332
-
- Community/Behavioral Health Agency
- Jasper, IN
- NPI 1487121687
O20040315000128, O20040805000332
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
O20040805000332
-
- Community/Behavioral Health Agency
- Tell City, IN
- NPI 1548737646
O20040315000128, O20040805000332
National Provider Directory
National Provider Directory- Tax ID family
- Lifespring Mental Healt
Other organizations with this tax ID 34
Organizations that report the same tax identification number in the National Provider Directory.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
-
dba New Albany Community Medical Services
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1750056461
-
dba Salem Community Schools Health Center
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1255006961
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jeffersonville, IN
- NPI 1043459894
-
- Community/Behavioral Health Agency
- English, IN
- NPI 1104393206
-
dba LifeSpring Washington County
- Community/Behavioral Health Agency
- Salem, IN
- NPI 1114788296
-
dba LifeSpring Orleans Health Center
- Family Medicine Physician
- Orleans, IN
- NPI 1124868740
-
dba Hope Center
- Substance Use Disorder Rehabilitation Clinic/Center
- Jasper, IN
- NPI 1164287595
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
Ownership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Alan Smock | Corporate Officer | Jul 1, 2022 | |
| Jacalyn Young | Corporate Officer | Jul 1, 2022 | |
| Emily Stumler | Corporate Officer | Jul 1, 2022 | |
| Paul Kiger | Corporate Officer | Jul 1, 2022 | |
| Melissa Campbell | Corporate Officer | Jul 1, 2022 | |
| Darnell Jackson | Corporate Officer | Jul 1, 2022 | |
| Lifespring, Inc | 5% Or Greater Direct Ownership Interest | Apr 15, 1966 | 100% |
| Margo Olson | Corporate Officer | May 1, 2023 | |
| Anne Beth Kenney | Corporate Officer | Jan 1, 2021 | |
| Corporate Director | Jan 1, 2021 | ||
| W-2 Managing Employee | Jan 1, 2021 | ||
| Operational/Managerial Control | Jan 1, 2021 | ||
| Wendy Broughton | Corporate Officer | Jul 1, 2022 | |
| Denise Eden | Corporate Officer | Jul 1, 2022 | |
| Rossina Sandoval Monsivais | Corporate Officer | Jul 1, 2022 | |
| Kenny Kavanaugh | Corporate Officer | Jul 1, 2022 | |
| Kristie Swoboda | Corporate Director | Sep 1, 2024 | |
| W-2 Managing Employee | Sep 1, 2024 | ||
| Ray Oppel | Corporate Officer | Jul 1, 2022 |
Owners & managing parties with NPI records 15
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
5% Or Greater Direct Ownership Interest
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
5% Or Greater Direct Ownership Interest
-
dba New Albany Community Medical Services
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1750056461
5% Or Greater Direct Ownership Interest
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
5% Or Greater Direct Ownership Interest
-
dba Salem Community Schools Health Center
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1255006961
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
5% Or Greater Direct Ownership Interest
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Orleans Family Health
- Federally Qualified Health Center (FQHC)
- Orleans, IN
- NPI 1265277883
5% Or Greater Direct Ownership Interest
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
5% Or Greater Direct Ownership Interest
-
dba Metro Mobile Unit
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1619698669
5% Or Greater Direct Ownership Interest
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1811512239
5% Or Greater Direct Ownership Interest
-
dba Southern Indiana Mental Health and Guidance Center of ECI
- Community/Behavioral Health Agency
- Jeffersonville, IN
- NPI 1851489942
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 12
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Lifespring Community Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2015 |
| Salem Community Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 15, 2016 |
| Lifespring Adult Integrated Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2019 |
| Austin Medical Center | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 16, 1966 |
| New Albany Student Health Center | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2024 |
| Jasper Community Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2024 |
| Metro Mobile Unit | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 16, 1966 |
| Dale Community Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2024 |
| Lifespring Orleans Family Health | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 24, 2024 |
| Charlestown Community Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 21, 2024 |
| Lifespring Forensics Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2024 |
| Floyd Central Student Health Center | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Nov 27, 2023 |
Owned or controlled facilities with NPI records 12
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
5% Or Greater Direct Ownership Interest
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
5% Or Greater Direct Ownership Interest
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
5% Or Greater Direct Ownership Interest
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Orleans Family Health
- Federally Qualified Health Center (FQHC)
- Orleans, IN
- NPI 1265277883
5% Or Greater Direct Ownership Interest
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
5% Or Greater Direct Ownership Interest
-
dba Metro Mobile Unit
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1619698669
5% Or Greater Direct Ownership Interest
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1811512239
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Adult Integrated Medical Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1861957706
5% Or Greater Direct Ownership Interest
-
dba Lifespring Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1982083564
5% Or Greater Direct Ownership Interest
-
dba Charlestown Community Medical Services
- Federally Qualified Health Center (FQHC)
- Charlestown, IN
- NPI 1992549398
5% Or Greater Direct Ownership Interest
Facilities with the same owner 12
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
Lifespring, Inc
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
Lifespring, Inc
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
Lifespring, Inc
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
Lifespring, Inc
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
Lifespring, Inc
-
dba LifeSpring Orleans Family Health
- Federally Qualified Health Center (FQHC)
- Orleans, IN
- NPI 1265277883
Lifespring, Inc
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
Lifespring, Inc
-
dba Metro Mobile Unit
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1619698669
Lifespring, Inc
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1811512239
Lifespring, Inc
-
dba LifeSpring Adult Integrated Medical Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1861957706
Lifespring, Inc
-
dba Lifespring Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1982083564
Lifespring, Inc
-
dba Charlestown Community Medical Services
- Federally Qualified Health Center (FQHC)
- Charlestown, IN
- NPI 1992549398
Lifespring, Inc
Practitioners & affiliated clinicians
Practitioners 7
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.
-
- School Psychologist
- Jeffersonville, IN
- NPI 1841337268
-
- Psychiatric/Mental Health Nurse Practitioner
- Jeffersonville, IN
- NPI 1558014407
-
- Social Worker
- Corydon, IN
- NPI 1184294043
-
- Social Worker
- Scottsburg, IN
- NPI 1669996948
-
- Clinical Social Worker
- New Albany, IN
- NPI 1154140358
-
- Psychiatric/Mental Health Nurse Practitioner
- Jeffersonville, IN
- NPI 1750101721
-
- Clinical Social Worker
- New Albany, IN
- NPI 1720411556
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1568073600000",
"number": "1700435948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "460 SPRING ST",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303452",
"telephone_number": "812-280-2080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "460 SPRING ST",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303452",
"telephone_number": "812-280-2080"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFESPRING, INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-10",
"last_updated": "2019-09-10",
"status": "A",
"authorized_official_last_name": "STAWAR",
"authorized_official_first_name": "TERRY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "812-206-1234"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jeffersonville, IN
- Lifespring Medical Services, Inc
- Lifespring Pharmacy
- Lifespring, Inc (LifeSpring Forensics Health Services)
- Lifespring, Inc
- Lifespring, Inc (LifeSpring Adult Behavioral Services)
- Lifespring, Inc (LifeSpring Forensics Clark County)
- Lifespring, Inc (LifeSpring Integrated Treatment Center)
- Lifespring, Inc (LifeSpring Turning Point Center)
- Lifespring, Inc
- Lifespring, Inc (Southern Indiana Mental Health and Guidance Center of ECI)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.