Lifeline Vascular Center Niceville LLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

LIFELINE VASCULAR CENTER NICEVILLE LLC

Practice address

4585 E Highway 20 Ste 125
Niceville, FL 32578-7709

Phone

(850) 678-0184

Fax

(850) 678-0155

NPI assigned

Jun 3, 2013

Last updated

Jun 30, 2021By 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

Jason Lohmeyer

Title

Cfo

Phone

(847) 949-3855

Specialties & licenses 3

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1962849794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 782282",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191782282",
            "telephone_number": "847-388-2001",
            "fax_number": "847-388-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 E HIGHWAY 20 STE 125",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787709",
            "telephone_number": "850-678-0184",
            "fax_number": "850-678-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE VASCULAR CENTER NICEVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "LOHMEYER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-949-3855"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Lemond Jr.
• Kyra Lenox
• Jaden Payge Lentz
• Mandy M Letort, M.ED.
• Liberty Applied Behavior Analysis
• Lincare Inc.
• Chastity Lynn Lindberg, CBD
• Lisa M Judge M D P a
• Kimberly J Litwiller, CRNP
• Andrea Lloyd, ARNP, PMHNP-BC

• Vascular & Interventional Radiology Physician in Niceville, FL
• Providers in Niceville, FL by specialty
• Vascular & Interventional Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.