Organization Active NPI

Lifesource Accountability Inc

  • Internal Medicine Physician
  • Wilmington, NC
National Provider Identifier
1790615425
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIFESOURCE ACCOUNTABILITY INC
Practice address
3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone
(910) 742-9243
Fax
(888) 746-1787
NPI assigned
May 22, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Authorized official

Name
Eryn Robbins
Title
Vice President of Operations
Phone
(910) 622-2319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565

Mailing address

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1779408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781222400000",
    "number": "1790615425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 RANDALL PKWY STE 105",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032565",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 RANDALL PKWY STE 105",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032565",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESOURCE ACCOUNTABILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-22",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A",
        "authorized_official_last_name": "ROBBINS",
        "authorized_official_first_name": "ERYN",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "910-622-2319"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.