Lifeline Vascular Center - Albany, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

LIFELINE VASCULAR CENTER - ALBANY, LLC

Doing business as

Vascular Health & Wellness Center

Practice address

2300 Dawson Rd Ste 100
Albany, GA 31707-2804

Phone

(229) 888-6466

Fax

(229) 888-5464

NPI assigned

Jan 25, 2013

Organization subpart

No

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

Authorized official

Name

Jason Lohmeyer

Title

Cfo

Phone

(847) 949-3855

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Vascular Health & Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  dba Cascade Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

Practitioners 4

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

• Tiffany Mike, NP

  • Nurse Practitioner
  • Macon, GA
  • NPI 1205659562
  Medicare reassignment Care Compare group NPD
• Joe Harris Morgan III, M.D.

  • Vascular Surgery Physician
  • Albany, GA
  • NPI 1427230150
  Medicare reassignment Care Compare group NPD
• Nicole Forrester Rucker, FNP-BC

  • Family Nurse Practitioner
  • Moultrie, GA
  • NPI 1467217232
  Medicare reassignment Care Compare group NPD
• Terry Joe Davis, FNP

  • Family Nurse Practitioner
  • Albany, GA
  • NPI 1497306781
  Medicare reassignment NPD

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1861730855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARKWAY NORTH BLVD STE 200S",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152534",
            "telephone_number": "847-388-2001",
            "fax_number": "847-388-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 DAWSON RD STE 100",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072804",
            "telephone_number": "229-888-6466",
            "fax_number": "229-888-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE VASCULAR CENTER - ALBANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "LOHMEYER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-949-3855"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003134472A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vascular Health & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vascular Health & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laurie Anne Lewis, CNM
• Melvin Lewis
• Nardriana K Lewis
• Liberty Bell Solutions LLC
• Life Therapy, Inc.
• Susan Lightle, MS, CCC-SLP
• Katherine Rose Liles, OT
• George Arthur Lilly Sr.
• Magdalene Lima-Fiallos, MS, CCC-SLP
• Limbcare Prosthetics & Orthotics of Ga

• Vascular Surgery Physician in Albany, GA
• Providers in Albany, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.