Organization Active NPI

Doctor for Life, LLC

  • Internal Medicine Physician
  • Greenville, SC
National Provider Identifier
1881028892
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DOCTOR FOR LIFE, LLC
Doing business as
Dr. For Life, LLC
Practice address
309 Tanner Rd
Greenville, SC 29607-5923
Phone
(864) 640-0009
Fax
(864) 558-0589
NPI assigned
Aug 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Authorized official

Name
Judith Richter
Title
Manager Assistant
Phone
(864) 202-7033

Specialties & licenses 1

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

Addresses

Primary practice location

309 Tanner Rd
Greenville, SC 29607-5923

Mailing address

309 Tanner Rd
Greenville, SC 29607-5923
Phone (864) 640-0009

Other identifiers 1

IdentifierTypeStateIssuer
GP6250MedicaidSC

Other names 1

  • Dr. For Life, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131114000858 SC Part B Supplier - Clinic/Group Practice 2264668540 Receives reassigned benefits from 2 practitioners
Practice locations: Greenville, SC
O20210901000186 SC MDPP Supplier - in-Person MDPP Supplier 2264668540 Practice locations: Greenville, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0992286Doctor for Life, LLC309 Tanner Road, Greenville, SC 29607Certificate of waiverMar 22, 2027

National Provider Directory

National Provider Directory

Locations

309 Tanner Rd
Greenville, SC 29607
Phone (864) 640-0009

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1881028892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 TANNER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075923",
            "telephone_number": "864-640-0009",
            "fax_number": "864-558-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 TANNER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075923",
            "telephone_number": "864-640-0009",
            "fax_number": "864-558-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR FOR LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "RICHTER",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "MANAGER ASSISTANT",
        "authorized_official_telephone_number": "864-202-7033"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6250",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. For Life, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.