Active NPI
Lifespring, Inc
Doing business as Lifespring Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- LIFESPRING, INC
- Doing business as
- Lifespring Community Medical Services
- Practice address
- 1036 Sharon Dr
Jeffersonville, IN 47130-4522 - Phone
- (812) 280-2080
- NPI assigned
- May 28, 2015
- Last updated
- Dec 20, 2023
- Organization subpart
- Yes
- Parent organization
- LIFESPRING, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Terry Lynn Stawar, ED.D
- Title
- Ceo
- Phone
- (812) 206-1234
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | NU | Primary |
Addresses
Primary practice location
1036 Sharon Dr
Jeffersonville, IN 47130-4522
Mailing address
1036 Sharon Dr
Jeffersonville, IN 47130-4522
Phone (812) 280-2080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 151959 | Other | IN | PTAN |
Other names 1
- Lifespring Community Medical Services
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040315000128 | IN | Part B Supplier - Clinic/Group Practice | 5294624508 |
Receives reassigned benefits from 66 practitioners 16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: New Albany, IN; Paoli, IN; Rockport, IN; Salem, IN; Scottsburg, IN; Tell City, IN; Jeffersonville, IN; Madison, IN… |
| O20040805000332 | IN | Part B Supplier - Clinic/Group Practice | 5294624508 |
Receives reassigned benefits from 115 practitioners 19 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Dale, IN; Tell City, IN; Scottsburg, IN; Salem, IN; Rockport, IN; Paoli, IN; New Albany, IN; Madison, IN… |
| O20150701000514 | IN | Part A Provider - Federally Qualified Health Center (FQHC) | 5294624508 | Practice locations: Jeffersonville, IN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1982083564. Details of each certification follow.
Federally qualified health center certification: CCN 151959
- Legal name
- LIFESPRING, INC
- Doing business as
- LIFESPRING COMMUNITY MEDICAL SERVICES
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 1, 2015
- Last certification
- Jul 1, 2015
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation
- Incorporated
- Apr 15, 1964 in IN
- Enrollment address
- 1036 Sharon Dr
Jeffersonville, IN 47130-4522
Other NPIs with the same Medicare PAC ID 15
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
5294624508
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
5294624508
-
dba New Albany Community Medical Services
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1750056461
5294624508
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
5294624508
-
dba Salem Community Schools Health Center
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1255006961
5294624508
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
5294624508
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
5294624508
-
dba LifeSpring Orleans Family Health
- Federally Qualified Health Center (FQHC)
- Orleans, IN
- NPI 1265277883
5294624508
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
5294624508
-
dba Metro Mobile Unit
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1619698669
5294624508
-
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1700435948
5294624508
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1811512239
5294624508
Other NPIs on the same Medicare enrollment 19
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
O20040315000128, O20040805000332
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
O20040315000128, O20040805000332
-
dba New Albany Community Medical Services
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1750056461
O20040315000128, O20040805000332
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1851751887
O20040315000128, O20040805000332
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
O20040315000128, O20040805000332
-
dba Salem Community Schools Health Center
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1255006961
O20040315000128, O20040805000332
-
- Community/Behavioral Health Agency
- English, IN
- NPI 1104393206
O20040315000128, O20040805000332
-
dba Hope Center
- Substance Use Disorder Rehabilitation Clinic/Center
- Jasper, IN
- NPI 1164287595
O20040805000332
-
dba Charlestown Behavioral Services
- Community/Behavioral Health Agency
- Charlestown, IN
- NPI 1457186355
O20040805000332
-
- Community/Behavioral Health Agency
- Jasper, IN
- NPI 1487121687
O20040315000128, O20040805000332
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
O20040805000332
-
- Community/Behavioral Health Agency
- Tell City, IN
- NPI 1548737646
O20040315000128, O20040805000332
National Provider Directory
National Provider Directory- Tax ID family
- Lifespring Inc
- Part of
- Lifespring Inc
Other organizations with this tax ID 34
Organizations that report the same tax identification number in the National Provider Directory.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
-
dba New Albany Community Medical Services
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1750056461
-
dba Salem Community Schools Health Center
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1255006961
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jeffersonville, IN
- NPI 1043459894
-
- Community/Behavioral Health Agency
- English, IN
- NPI 1104393206
-
dba LifeSpring Washington County
- Community/Behavioral Health Agency
- Salem, IN
- NPI 1114788296
-
dba LifeSpring Orleans Health Center
- Family Medicine Physician
- Orleans, IN
- NPI 1124868740
-
dba Hope Center
- Substance Use Disorder Rehabilitation Clinic/Center
- Jasper, IN
- NPI 1164287595
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
Locations
460 Spring St
Ste 1
Jeffersonville, IN 47130
1020 Vincennes St
New Albany, IN 47150
Phone (812) 542-8506
Ownership & related parties
All disclosed owners & managing parties 13
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Tonya S Heim | Corporate Director | Jan 1, 2022 | |
| Alan Smock | Corporate Director | Jan 1, 2022 | |
| Emily Stumler | Corporate Director | Jan 1, 2022 | |
| Christine Grider | Corporate Officer | Jan 1, 2017 | |
| W-2 Managing Employee | Jan 1, 2017 | ||
| Susan Umpleby | Corporate Director | Jan 1, 2022 | |
| Randal Dennison | Corporate Director | Jan 1, 2022 | |
| Lifespring, Inc | 5% Or Greater Direct Ownership Interest | Jul 1, 2015 | 100% |
| Anne Beth Kenney | Corporate Officer | Jan 1, 2022 | |
| W-2 Managing Employee | Jan 1, 2022 | ||
| Operational/Managerial Control | Jan 1, 2022 | ||
| Lindsey Fleming | Corporate Director | Nov 1, 2013 | |
| Wendy Broughton | Corporate Director | Jan 1, 2022 | |
| Denise Eden | Corporate Director | Jan 1, 2022 | |
| Christopher Hollinden | Corporate Director | Jan 1, 2022 | |
| Ray Oppel | Corporate Director | Jan 1, 2022 |
Owners & managing parties with NPI records 15
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
5% Or Greater Direct Ownership Interest
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
5% Or Greater Direct Ownership Interest
-
dba New Albany Community Medical Services
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1750056461
5% Or Greater Direct Ownership Interest
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
5% Or Greater Direct Ownership Interest
-
dba Salem Community Schools Health Center
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1255006961
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
5% Or Greater Direct Ownership Interest
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Orleans Family Health
- Federally Qualified Health Center (FQHC)
- Orleans, IN
- NPI 1265277883
5% Or Greater Direct Ownership Interest
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
5% Or Greater Direct Ownership Interest
-
dba Metro Mobile Unit
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1619698669
5% Or Greater Direct Ownership Interest
-
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1700435948
5% Or Greater Direct Ownership Interest
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1811512239
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 12
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Salem Community Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Dec 15, 2016 |
| Lifespring Adult Integrated Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2019 |
| Lifespring, Inc | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 15, 1966 |
| Austin Medical Center | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 16, 1966 |
| New Albany Student Health Center | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2024 |
| Jasper Community Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2024 |
| Metro Mobile Unit | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 16, 1966 |
| Dale Community Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2024 |
| Lifespring Orleans Family Health | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 24, 2024 |
| Charlestown Community Medical Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 21, 2024 |
| Lifespring Forensics Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2024 |
| Floyd Central Student Health Center | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Nov 27, 2023 |
Owned or controlled facilities with NPI records 12
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
5% Or Greater Direct Ownership Interest
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
5% Or Greater Direct Ownership Interest
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
5% Or Greater Direct Ownership Interest
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Orleans Family Health
- Federally Qualified Health Center (FQHC)
- Orleans, IN
- NPI 1265277883
5% Or Greater Direct Ownership Interest
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
5% Or Greater Direct Ownership Interest
-
dba Metro Mobile Unit
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1619698669
5% Or Greater Direct Ownership Interest
-
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1700435948
5% Or Greater Direct Ownership Interest
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1811512239
5% Or Greater Direct Ownership Interest
-
dba LifeSpring Adult Integrated Medical Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1861957706
5% Or Greater Direct Ownership Interest
-
dba Charlestown Community Medical Services
- Federally Qualified Health Center (FQHC)
- Charlestown, IN
- NPI 1992549398
5% Or Greater Direct Ownership Interest
Facilities with the same owner 12
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba New Albany Student Health Center
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1326611187
Lifespring, Inc
-
dba Salem Community Medical Services
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1568907673
Lifespring, Inc
-
dba Jasper Community Medical Services
- Federally Qualified Health Center (FQHC)
- Jasper, IN
- NPI 1023681889
Lifespring, Inc
-
dba LifeSpring Forensics Health Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1043010077
Lifespring, Inc
-
dba Dale Community Medical Services
- Federally Qualified Health Center (FQHC)
- Dale, IN
- NPI 1205673084
Lifespring, Inc
-
dba LifeSpring Orleans Family Health
- Federally Qualified Health Center (FQHC)
- Orleans, IN
- NPI 1265277883
Lifespring, Inc
-
dba Floyd County Student Health Center
- Federally Qualified Health Center (FQHC)
- Floyds Knobs, IN
- NPI 1497522692
Lifespring, Inc
-
dba Metro Mobile Unit
- Federally Qualified Health Center (FQHC)
- New Albany, IN
- NPI 1619698669
Lifespring, Inc
-
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1700435948
Lifespring, Inc
-
dba Austin Medical Center
- Federally Qualified Health Center (FQHC)
- Austin, IN
- NPI 1811512239
Lifespring, Inc
-
dba LifeSpring Adult Integrated Medical Services
- Federally Qualified Health Center (FQHC)
- Jeffersonville, IN
- NPI 1861957706
Lifespring, Inc
-
dba Charlestown Community Medical Services
- Federally Qualified Health Center (FQHC)
- Charlestown, IN
- NPI 1992549398
Lifespring, Inc
Practitioners & affiliated clinicians
Practitioners 14
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.
-
- School Psychologist
- Jeffersonville, IN
- NPI 1841337268
-
- Clinical Social Worker
- Jeffersonville, IN
- NPI 1184322562
-
- Family Nurse Practitioner
- Jeffersonville, IN
- NPI 1275400574
-
- Family Nurse Practitioner
- Jeffersonville, IN
- NPI 1184388142
-
- Physician Assistant
- Jasper, IN
- NPI 1659071652
-
- Psychiatric/Mental Health Nurse Practitioner
- Jeffersonville, IN
- NPI 1548766181
-
- Clinical Social Worker
- Louisville, KY
- NPI 1760913404
-
- Family Nurse Practitioner
- Louisville, KY
- NPI 1942679063
-
- Family Nurse Practitioner
- Louisville, KY
- NPI 1174285233
-
- Clinical Social Worker
- North Smithfield, RI
- NPI 1376438143
-
- Clinical Social Worker
- Jeffersonville, IN
- NPI 1598810293
-
- Primary Care Nurse Practitioner
- New Albany, IN
- NPI 1750838066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1703030400000",
"number": "1982083564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1036 SHARON DR",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471304522",
"telephone_number": "812-280-2080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1036 SHARON DR",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471304522",
"telephone_number": "812-280-2080"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFESPRING, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LIFESPRING, INC.",
"enumeration_date": "2015-05-28",
"last_updated": "2023-12-20",
"certification_date": "2023-12-20",
"status": "A",
"authorized_official_last_name": "STAWAR",
"authorized_official_first_name": "TERRY",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "812-206-1234",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "ED.D"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "151959",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lifespring Community Medical Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jeffersonville, IN
- Lifespring, Inc (LifeSpring Integrated Treatment Center)
- Lifespring, Inc (LifeSpring Turning Point Center)
- Lifespring, Inc
- Lifespring, Inc (Southern Indiana Mental Health and Guidance Center of ECI)
- Lifespring, Inc (LifeSpring Adult Integrated Medical Services)
- Liliana Torres-Popp, M.D., P.S.C. (Liliana Torres-Popp, M.D.)
- Limestone Dentistry LLC
- John Eric Lindner, MD
- Robert M Lindner, MD
- Ashley Lindsey, PMHNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.