Lifetime Skin Care Centers, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LIFETIME SKIN CARE CENTERS, LLC

Doing business as

Lifetime Skin Care Centers

Practice address

401 W McGalliard Rd
Muncie, IN 47303-1828

Phone

(765) 288-6200

Fax

(765) 288-4131

NPI assigned

Apr 20, 2006

Last updated

Sep 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Drew Anderson, M.D.NPI 1609832377

Title

Owner

Phone

(765) 288-6200

Specialties & licenses 1

Addresses

Other names 1

• Lifetime Skin Care Centers Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Drew Munson Anderson, M.D.

  • Dermatology Physician
  • Muncie, IN
  • NPI 1609832377
  Medicare reassignment Care Compare group NPD Authorized official
• Michelle L Hicks, N.P.

  • Nurse Practitioner
  • Muncie, IN
  • NPI 1912147943
  Medicare reassignment Care Compare group NPD
• Nico Mousdicas, MD

  • Dermatology Physician
  • Carmel, IN
  • NPI 1144238650
  Medicare reassignment Care Compare group NPD
• Elizabeth Anne Peacock, M.D.

  • Dermatology Physician
  • Muncie, IN
  • NPI 1679968986

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Rachel Ward, M.D.

  • MOHS-Micrographic Surgery Physician
  • Muncie, IN
  • NPI 1710373378

  Dermatology

  Medicare reassignment Care Compare group NPD
• Lauren C Kisan, PA

  • Physician Assistant
  • Muncie, IN
  • NPI 1407633894
  Medicare reassignment Care Compare group
• Steve George Bekas, M.D.

  • Dermatology Physician
  • Muncie, IN
  • NPI 1386600088
  Medicare reassignment NPD
• Andrew Michael Ellenwood, FNP-C

  • Nurse Practitioner
  • Fishers, IN
  • NPI 1689044117
  Medicare reassignment NPD
• Deborah Sue Kuhlman, M.D.

  • Dermatology Physician
  • Muncie, IN
  • NPI 1417912528
  Medicare reassignment NPD
• Jessica Louise Jones, DO

  • Dermatology Physician
  • Midland, MI
  • NPI 1962922252

  IN

  Medicare reassignment NPD

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1902861016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473031828",
            "telephone_number": "765-288-6200",
            "fax_number": "765-288-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473031828",
            "telephone_number": "765-288-6200",
            "fax_number": "765-288-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME SKIN CARE CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-288-6200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Skin Care Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifetime Skin Care Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lacey Lewis, MA, BCBA
• Laura Lewis, MOT
• Sherry D Lewis, R.N.C.,N.P.
• Kaitlynn Licht-Freimanis, FNP
• Lifetime Counseling Services
• Light Haven: a Second Chances Company
• Tammy Lightner, NP
• Lil Family Inc
• Robert A Lillo, MD
• Jariel Lilly

• Dermatology Physician in Muncie, IN
• Providers in Muncie, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.