Uchee Pines Lifestyle Center – Specialist

Key facts

NPI: 1891798930
Entity type: Organization (NPI type 2)
Primary specialty: Specialist 174400000X
License: 00019762 (AL)
Legal business name: UCHEE PINES LIFESTYLE CENTER
Practice address: 30 Uchee Pines Rd
Lot 75
Seale, AL 36875-5726
Phone: (334) 855-4763
Fax: (334) 855-9014
NPI assigned: May 23, 2005
Organization subpart: No

Authorized official

Name: Dr. James Irwin Horsley, M.D.
Title: Medical Director
Phone: (334) 855-4764

Practitioners 3

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

Jacqueline Maida Bergdoll, M.D. General Practice Physician · Seale, AL · NPI 1174749717

NPD (past)
James Irwin Horsley, M.D. General Practice Physician · Seale, AL · NPI 1073642880

NPD (past)
David K Miller, MD General Practice Physician · Tulsa, OK · NPI 1437253176

NPD (past)

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
01D0870902	Uchee Pines Lifestyle Center 30 Uchee Pines Rd #75, Seale, AL 36875	Certificate of waiver	Aug 31, 2026
01D1045516	Uchee Pines Lifestyle Center 30 Uchee Pines Road Suite #75, Seale, AL 36875	Certificate of waiver	Sep 15, 2027

National Provider Directory

Locations

30 Uchee Pines Rd
Lot 75
Seale, AL 36875
Phone (334) 855-3912

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Specialist Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	174400000X	00019762	AL	Yes
Specialist Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	174400000X	4123	AL
Specialist Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	174400000X	025873	GA
Specialist Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	174400000X	007539	GA
Specialist Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	174400000X	04837	GA

Addresses

Primary practice location

30 Uchee Pines Rd
Lot 75
Seale, AL 36875-5726

Mailing address

30 Uchee Pines Road
#75
Seale, AL 36875-5715
Phone (334) 855-4763

Other names

Anvwodi Other name

Other providers in Seale, AL

All providers in Seale, AL · Specialist in Alabama

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Care Compare provider data (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.