NPIMap

Organization Active NPI

Lifeway Family Physicians PC

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1972672731
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFEWAY FAMILY PHYSICIANS PC
Practice address
1821 Old Donation Pkwy
Suite #4
Virginia Beach, VA 23454-3033
Phone
(757) 496-4916
Fax
(757) 496-4046
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Authorized official

Name
Deirdre Barnes
Title
Manager
Phone
(757) 496-4916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1821 Old Donation Pkwy
Suite #4
Virginia Beach, VA 23454-3033

Mailing address

1821 Old Donation Pkwy
Suite #4
Virginia Beach, VA 23454-3033
Phone (757) 496-4916

Other identifiers 3

IdentifierTypeStateIssuer
1205801719OtherVAMEDICARE NUMBER
080008247OtherVAMEDICARE NUMBER
1194806307OtherVAMEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040805001541 VA Part B Supplier - Clinic/Group Practice 8921079492 Receives reassigned benefits from 5 practitioners
Practice locations: Virginia Beach, VA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1000548Lifeway Family Physicians1821 Old Donatation Parkway - Suite 4, Virginia Beach, VA 23454Provider-performed microscopyJun 17, 2028

National Provider Directory

National Provider Directory

Locations

1821 Old Donation Pkwy
Ste 4
Virginia Beach, VA 23454
Phone (757) 481-3350

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1972672731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 OLD DONATION PKWY",
            "address_2": "SUITE #4",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543033",
            "telephone_number": "757-496-4916",
            "fax_number": "757-496-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 OLD DONATION PKWY",
            "address_2": "SUITE #4",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543033",
            "telephone_number": "757-496-4916",
            "fax_number": "757-496-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWAY FAMILY PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "757-496-4916"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "1205801719",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "080008247",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "1194806307",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.