Organization Active NPI

Lifespring, Inc

Doing business as Austin Medical Center

  • Federally Qualified Health Center (FQHC)
  • Austin, IN
National Provider Identifier
1811512239
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LIFESPRING, INC
Doing business as
Austin Medical Center
Practice address
2277 W Frontage Rd
Austin, IN 47102-8820
Phone
(812) 413-3117
NPI assigned
Jun 11, 2020
Last updated
Jul 20, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFESPRING, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

2277 W Frontage Rd
Austin, IN 47102-8820

Mailing address

460 Spring St
Jeffersonville, IN 47130-3452
Phone (812) 206-1362

Other names 1

  • AUSTIN MEDICAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
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…
O20200615000165 IN Part A Provider - Federally Qualified Health Center (FQHC) 5294624508 Practice locations: Austin, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811512239. Details of each certification follow.

Federally qualified health center certification: CCN 151081

Legal name
LIFESPRING, INC
Doing business as
AUSTIN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 12, 2020
Last certification
Jun 12, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
2277 W Frontage Rd
Austin, IN 47102-8820

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Lifespring Mental Healt35 organizations share this tax ID, including this one
Part of
Lifespring Mental Healt

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Alan Smock Individual Corporate DirectorBoard Member Jan 1, 2022
Jacalyn Young Individual Corporate DirectorBoard Member Jul 23, 2025
Emily Stumler Individual Corporate DirectorBoard Member Jan 1, 2022
Paul Kiger Individual Corporate OfficerBoard Member Jul 23, 2025
Misty L Kannapel Gilbert Individual Corporate DirectorCoo Jun 1, 2024
Nick Clark Individual Corporate DirectorCfo Jun 1, 2024
Melissa Campbell Individual Corporate OfficerBoard Member Jul 23, 2025
Darnell Jackson Individual Corporate OfficerBoard Member Jul 23, 2025
Lifespring, Inc Organization, Jeffersonville, IN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 16, 1966 100%
Margo Olson Individual Corporate OfficerBoard Member Jul 23, 2025
Anne Beth Kenney Individual Corporate OfficerCeo Jan 1, 2021
W-2 Managing EmployeeCeo Jan 1, 2021
Operational/Managerial ControlCeo Jan 1, 2021
Wendy Broughton Individual Corporate DirectorBoard Member Jan 1, 2022
Denise Eden Individual Corporate DirectorBoard Member Jan 1, 2022
Rossina Sandoval Monsivais Individual Corporate OfficerBoard Member Jul 23, 2025
Kenny Kavanaugh Individual Corporate OfficerBoard Member Jul 23, 2025
Kristie Swoboda Individual Corporate DirectorPractice Manager Director Jun 1, 2024
Ray Oppel Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 16

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 16

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lifespring Community Medical ServicesJeffersonville, IN, CCN 151959 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Salem Community Medical ServicesSalem, IN, CCN 151979 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 15, 2016
Lifespring Adult Integrated Medical ServicesJeffersonville, IN, CCN 151037 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2019
Lifespring, IncJeffersonville, IN, CCN 151058 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 15, 1966
New Albany Student Health CenterNew Albany, IN, CCN 151113 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
Jasper Community Medical ServicesJasper, IN, CCN 151115 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
Metro Mobile UnitNew Albany, IN, CCN 151156 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 16, 1966
Dale Community Medical ServicesDale, IN, CCN C51081 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2024
Lifespring Orleans Family HealthOrleans, IN, CCN C51090 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 24, 2024
Charlestown Community Medical ServicesCharlestown, IN, CCN C51088 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 21, 2024
Lifespring Forensics Health ServicesJeffersonville, IN, CCN C51089 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
Floyd Central Student Health CenterFloyds Knobs, IN, CCN C51107 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.

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1811512239",
    "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": "812-206-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 W FRONTAGE RD",
            "city": "AUSTIN",
            "state": "IN",
            "postal_code": "471028820",
            "telephone_number": "812-413-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPRING, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESPRING, INC",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "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
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AUSTIN MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AUSTIN MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, IN

Sources for this page

Verify at the official NPI Registry.