NPIMap

Organization Active NPI

Lifespring, Inc

  • Federally Qualified Health Center (FQHC)
  • Charlestown, IN
National Provider Identifier
1992549398
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LIFESPRING, INC
Practice address
890 Main St
Charlestown, IN 47111-1220
Phone
(812) 503-3040
NPI assigned
Jun 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Kristie Swoboda
Title
Practice Management Administrator
Phone
(812) 206-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

890 Main St
Charlestown, IN 47111-1220

Mailing address

460 Spring St
Jeffersonville, IN 47130-3452
Phone (812) 280-2080

Other names 1

  • Charlestown Community Medical Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250421001564 IN Part A Provider - Federally Qualified Health Center (FQHC) 5294624508 Practice locations: Charlestown, IN

Federally qualified health center certification: CCN C51088

Legal name
LIFESPRING, INC
Doing business as
CHARLESTOWN COMMUNITY MEDICAL SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 11, 2025
Last certification
Apr 11, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 14, 1964 in IN
Enrollment address
890 Main St
Charlestown, IN 47111-1220

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

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
15D2314043Charlestown Community Medical890 Main St, Charlestown, IN 47111Certificate of waiverNov 11, 2026

National Provider Directory

National Provider Directory
Tax ID family
Lifespring Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tiffany Pollock Individual OtherCredentialing Specialist Aug 21, 2024
Alan Smock Individual Corporate OfficerBoard Treasurer Aug 21, 2024
Jacalyn Young Individual Corporate OfficerBoard Secretary Aug 21, 2024
Emily Stumler Individual Corporate OfficerBoard Member Aug 21, 2024
Paul Kiger Individual Corporate OfficerBoard Member Aug 21, 2024
Misty L Kannapel Gilbert Individual Corporate DirectorCoo Aug 21, 2024
Nick Clark Individual Corporate DirectorCfo Aug 21, 2024
Melissa Campbell Individual Corporate OfficerBoard Member Aug 21, 2024
Darnell Jackson Individual Corporate OfficerBoard Chair Aug 21, 2024
Lifespring, Inc Organization, Jeffersonville, IN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 21, 2024 100%
Margo Olson Individual Corporate OfficerBoard Member Aug 21, 2024
Anne Beth Kenney Individual Corporate DirectorCeo Aug 21, 2024 100%
W-2 Managing EmployeeCeo Aug 21, 2024 100%
Wendy Broughton Individual Corporate OfficerBoard Member Aug 21, 2024
Denise Eden Individual Corporate OfficerBoard Member Aug 21, 2024
Rossina Sandoval Monsivais Individual Corporate OfficerBoard Chair-Elect Aug 21, 2024
Kenny Kavanaugh Individual Corporate OfficerBoard Member Aug 21, 2024
Kristie Swoboda Individual Corporate DirectorPractice Management Director Aug 21, 2024
Ray Oppel Individual Corporate OfficerBoard Member Aug 21, 2024

Owners & managing parties with NPI records 16

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 16

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lifespring Community Medical ServicesJeffersonville, IN, CCN 151959 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2015
Salem Community Medical ServicesSalem, IN, CCN 151979 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 15, 2016
Lifespring Adult Integrated Medical ServicesJeffersonville, IN, CCN 151037 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2019
Lifespring, IncJeffersonville, IN, CCN 151058 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 15, 1966
Austin Medical CenterAustin, IN, CCN 151081 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 16, 1966
New Albany Student Health CenterNew Albany, IN, CCN 151113 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
Jasper Community Medical ServicesJasper, IN, CCN 151115 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
Metro Mobile UnitNew Albany, IN, CCN 151156 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 16, 1966
Dale Community Medical ServicesDale, IN, CCN C51081 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2024
Lifespring Orleans Family HealthOrleans, IN, CCN C51090 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 24, 2024
Lifespring Forensics Health ServicesJeffersonville, IN, CCN C51089 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
Floyd Central Student Health CenterFloyds Knobs, IN, CCN C51107 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.

  • Lifespring Inc
    • Federally Qualified Health Center (FQHC)
    • New Albany, IN
    • NPI 1326611187

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring Inc
    • Federally Qualified Health Center (FQHC)
    • Salem, IN
    • NPI 1568907673

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring Inc.
    • Federally Qualified Health Center (FQHC)
    • Jasper, IN
    • NPI 1023681889

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring, Inc
    • Federally Qualified Health Center (FQHC)
    • Jeffersonville, IN
    • NPI 1043010077

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring, Inc
    • Federally Qualified Health Center (FQHC)
    • Dale, IN
    • NPI 1205673084

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring, Inc
    • Federally Qualified Health Center (FQHC)
    • Orleans, IN
    • NPI 1265277883

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring, Inc
    • Federally Qualified Health Center (FQHC)
    • Floyds Knobs, IN
    • NPI 1497522692

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring, Inc
    • Federally Qualified Health Center (FQHC)
    • New Albany, IN
    • NPI 1619698669

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring, Inc
    • Federally Qualified Health Center (FQHC)
    • Jeffersonville, IN
    • NPI 1700435948

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring, Inc
    • Federally Qualified Health Center (FQHC)
    • Austin, IN
    • NPI 1811512239

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring, Inc
    • Federally Qualified Health Center (FQHC)
    • Jeffersonville, IN
    • NPI 1861957706

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lifespring, Inc
    • Federally Qualified Health Center (FQHC)
    • Jeffersonville, IN
    • NPI 1982083564

    5% Or Greater Direct Ownership Interest

    CMS ownership

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 65

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

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1992549398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 SPRING ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303452",
            "telephone_number": "812-280-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 MAIN ST",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471111220",
            "telephone_number": "812-503-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPRING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "SWOBODA",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "PRACTICE MANAGEMENT ADMINISTRATOR",
        "authorized_official_telephone_number": "812-206-1249"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlestown Community Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlestown, IN

Sources for this page

Verify at the official NPI Registry.