Livewell Health Services

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

75651 Issued in GA

Legal business name

LIVEWELL HEALTH SERVICES

Practice address

1250B Auburn Rd Ste 202
Dacula, GA 30019-5433

Phone

(678) 689-6888

NPI assigned

Jul 17, 2018

Last updated

Jul 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bertram Prosser

Title

Owner

Phone

(678) 689-6880

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Logoi B Davis, PA

  • Medical Physician Assistant
  • Gainesville, GA
  • NPI 1558389817
  NPD

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1730665365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250B AUBURN RD STE 202",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195433",
            "telephone_number": "678-689-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250B AUBURN RD STE 202",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195433",
            "telephone_number": "678-689-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVEWELL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "PROSSER",
        "authorized_official_first_name": "BERTRAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-689-6880"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "75651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lentz, MD
• Michael F Leonard, FNP
• Lifesight Therapy Services, LLC
• Lanny Brian Lightfoot, M.S.
• Gretchen Lionberger
• Living Renewed, Inc.
• Living Water ABA LLC
• Kang-Sha Lo
• Justin Wayne Long, MPT
• Haley Lorimer, MS, CCC-SLP

• Family Medicine Physician in Dacula, GA
• Providers in Dacula, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; 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.