Lifehope Trif3Cta Sports Medicine, LLC

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

Legal business name

LIFEHOPE TRIF3CTA SPORTS MEDICINE, LLC

Practice address

11680 Great Oaks Way
Alpharetta, GA 30022-2457

Phone

(404) 500-7224

NPI assigned

Sep 20, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jaeson Courseault

Title

Owner

Phone

(504) 982-7141

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1841960937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11680 GREAT OAKS WAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300222457",
            "telephone_number": "404-500-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11680 GREAT OAKS WAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300222457",
            "telephone_number": "404-500-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEHOPE TRIF3CTA SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "COURSEAULT",
        "authorized_official_first_name": "JAESON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-982-7141",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Internal Medicine) Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Sports Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.