Life Connect Health LLC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD0000029394 Issued in TN

Legal business name

LIFE CONNECT HEALTH LLC

Practice address

415 Church St
Unit 2802
Nashville, TN 37219

Phone

(276) 356-5262

NPI assigned

Sep 30, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jana K Dreyzehner, MDNPI 1063407773

Title

Ceo

Phone

(844) 800-2735

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, VA, NM, NC5 enrollments

Enrollment records 5

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jana K Dreyzehner, MD

  • Psychiatry Physician
  • Clintwood, VA
  • NPI 1063407773

  Child & Adolescent Psychiatry, NC, NM, TN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598486400000",
    "number": "1841693215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 CHURCH ST",
            "address_2": "UNIT 2802",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191847",
            "telephone_number": "844-800-2735",
            "fax_number": "844-800-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 CHURCH ST",
            "address_2": "UNIT 2802",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37219",
            "telephone_number": "276-356-5262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Wesley St",
            "address_2": "Suite 10",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011740",
            "country_code": "US",
            "telephone_number": "844-800-2735",
            "fax_number": "844-800-2735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE CONNECT HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "DREYZEHNER",
        "authorized_official_first_name": "JANA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "844-800-2735",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "MD0000029394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945581",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3821648",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.lifeconnecthealth.com/make-a-referral",
            "affiliation": "N",
            "endpointDescription": "Electronic Referral Form",
            "address_1": "415 Church St",
            "address_2": "Unit 2802",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Olga Kalitovna L Lieberman
• Nicole Liernur
• Alyssa Lietz
• Life Action Tennessee, Inc.
• Life Bridge Dental TN PLLC
• Life Coordinated Inc
• Life Dental Tennessee PLLC
• Life Occupational Therapy Services, PLLC
• Life Recovery and Support
• Life Watch Pharmacy LLC (LifeWatch Pharmacy)

• Child & Adolescent Psychiatry Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Child & Adolescent Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.