Life Orthopaedic & Spine Center

Primary specialty

SpecialistTaxonomy code 174400000X

License

0620697 Issued in GA

Legal business name

LIFE ORTHOPAEDIC & SPINE CENTER

Practice address

6584 Professional PL
Suite a
Riverdale, GA 30274-4942

Phone

(770) 477-1115

Fax

(770) 477-1119

NPI assigned

Dec 17, 2009

Last updated

May 4, 2016By 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

Dr. Dashawn Bakari, M.D.NPI 1184801276

Title

Owner

Phone

(770) 477-1115

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Life Orthopaedic and Spine Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Life Orthopaedic & Spine Center

  • Physical Medicine & Rehabilitation Physician
  • Dunwoody, GA
  • NPI 1801282546
  NPD tax ID

Locations

Practitioners 1

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.

• Dashawn Bakari, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Riverdale, GA
  • NPI 1184801276
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462320000000",
    "number": "1922337120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6584 PROFESSIONAL PL",
            "address_2": "SUITE A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744942",
            "telephone_number": "770-477-1115",
            "fax_number": "770-477-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6584 PROFESSIONAL PL",
            "address_2": "SUITE A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744942",
            "telephone_number": "770-477-1115",
            "fax_number": "770-477-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ORTHOPAEDIC & SPINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2016-05-04",
        "status": "A",
        "authorized_official_last_name": "BAKARI",
        "authorized_official_first_name": "DASHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-477-1115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "0620697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032883905A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Life Changers Community Empowerment Enterprises, Inc
• Life Cycle OB/GYN, LLC
• Life Cycle OB/GYN, LLC
• Life Cycle Pediatrics
• Life Cycle Pediatrics, LLC
• Life Rediscovery Center, LLC
• Lifestyle Therapy Center, LLC
• James L Lindsey
• Michelle Little
• Living Well Healthcare Services LLC

• Specialist in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.