Organization Active NPI

Total Life Care LLC

  • Adult Health Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1952646754
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
TOTAL LIFE CARE LLC
Practice address
301 W Pine St
Hattiesburg, MS 39401-3829
Phone
(601) 544-0029
Fax
(601) 544-0780
NPI assigned
Dec 5, 2012
Last updated
Dec 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Authorized official

Name
Ms. Precia Pedersen
Title
Office Manager
Phone
(601) 544-0029

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NU Primary

Addresses

Primary practice location

301 W Pine St
Hattiesburg, MS 39401-3829

Mailing address

301 W Pine St
Hattiesburg, MS 39401-3829
Phone (601) 544-0029

National Provider Directory

National Provider Directory

Locations

301 W Pine St
Hattiesburg, MS 39401
Phone (601) 544-0029

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1952646754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W PINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013829",
            "telephone_number": "601-544-0029",
            "fax_number": "601-544-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W PINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013829",
            "telephone_number": "601-544-0029",
            "fax_number": "601-544-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL LIFE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "PRECIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-544-0029",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.