Lifelinc Direct Care PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

LIFELINC DIRECT CARE PLLC

Practice address

2207 Moody Ridge Rd
Scottsboro, AL 35768-4113

Phone

(256) 912-0341

Fax

(256) 912-0341

NPI assigned

Mar 29, 2016

Organization subpart

No

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

Authorized official

Name

Erica N Warren

Title

Coo

Phone

(901) 844-1590

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1790148740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 PLAYERS CLUB PKWY",
            "address_2": "SUITE 350",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258933",
            "telephone_number": "866-362-6963",
            "fax_number": "866-362-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 MOODY RIDGE RD",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684113",
            "telephone_number": "256-912-0341",
            "fax_number": "256-912-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINC DIRECT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "901-844-1590"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Scottsboro, AL
• Providers in Scottsboro, AL by specialty
• General Practice Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.