LIFE UNIVERSITY (NPI# 1063033942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063033942 |
| Entity Type | Organization |
| Organization Name | LIFE UNIVERSITY |
| Other Organization Name | LIFE CHIROPRACTIC CENTERS - MIDTOWN |
| Practice Address |
1 Baltimore P1. Nw Suite 100 Atlanta GA 30308 |
| Practice Telephone | 6783314500 |
| Practice Fax Number | 6783314500 |
| Mailing Telephone | 6783314500 |
| Mailing Fax Number | 6783314500 |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2020-05-05 |
| Authorized Official Name | WILLIAM D. JARR (EXECUTIVE VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 7704262623 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFE UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Life Chiropractic Centers - Midtown | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1780082404 | Life University | Clinic/Center | 1415 Barclay Cir Se, Marietta, GA 30060-2943 | 2014-12-11 |
| 1902033343 | Life University | Clinic/Center | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2009-06-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | LIFE UNIVERSITY | 655 Nw 195th St, Shoreline, WA 30060-2673 |
| Street Address |
1 BALTIMORE P1. NW SUITE 100 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285165 | Grace Mckinnon Cutchin | Speech-Language Pathologist | 550 Peachtree St. Ne, 9th Floor, Suite 4400, Atlanta, GA 30308 | 2020-08-10 |
| 1184254591 | Jordan Cohen | Specialist | 1075 Peachtree Rd, Suite 300, Atlanta, GA 30308 | 2020-01-24 |
| 1104463819 | Gary Sydney Koech IIi | Registered Nurse | Emory Midtown- Davis Fischer Bld 3rd Floor, Rm 3245a, 550 Peachtree Street, N.e., Atlanta, GA 30308 | 2019-12-02 |
| 1639728207 | Shannon Oliver Sullivan | Counselor | 1 Baltimore Pl Nw, Suite 360, Atlanta, GA 30308 | 2019-09-06 |
| 1477110187 | Ariel Alibey | Preventive Medicine | 550 Peachtree St Ne Bldg 4th, Atlanta, GA 30308 | 2019-05-29 |
| 1972075497 | Laura Mcrae | Nurse Practitioner | Emory Center for Critical Care, 550 Peachtree Street, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-21 |
| 1265902134 | Kyle Brooks Kraft | Nurse Practitioner | 550 Peachtree Road, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-04 |
| 1396211025 | Vita Judkins | Pharmacist | 240 Renaissance Pkway Ne, Unit 116, Atlanta, GA 30308 | 2018-10-20 |
| 1407345911 | Caitlin Cundiff | Anesthesiology | 550 Peachtree St Ne Ste 3245b, Atlanta, GA 30308 | 2018-05-09 |
| 1699273524 | Alexandra Duvall Hurst | Physician Assistant | 550 Peachtree St Ne Frnt 3245a, Atlanta, GA 30308 | 2018-01-25 |
| Find all providers in zip 30308 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
| 1154937050 | Staywellatl,llc | Clinic/Center | 2550 Heritage Ct Se Ste 135, Atlanta, GA 30339-3528 | 2020-09-17 |
| 1164035564 | The Lotus Haven PC | Clinic/Center | 950 Dannon Vw Sw Ste 4101, Atlanta, GA 30331-2159 | 2020-08-25 |
| 1801429105 | Pt Hills Place Terraces LLC | Clinic/Center | 229 Peachtree Hills Ave Ne, Atlanta, GA 30305-4411 | 2020-02-15 |
| 1194363382 | Arcd and Weightloss Management | Clinic/Center | 265 18th St Nw Ste 2823, Atlanta, GA 30363-1125 | 2019-12-18 |
| 1134775208 | Naesm Mens Health and Wellness Center | Clinic/Center | 2140 Martin Luther King Jr Dr Sw Ste 201, Atlanta, GA 30310 | 2019-08-14 |
| 1427532225 | River Acupuncture Inc | Clinic/Center | 5441 Buford Hwy Ne Ste 203, Atlanta, GA 30340-1168 | 2018-09-18 |
| 1093208381 | Tonova Audiometrics, LLC | Clinic/Center | 677b Alta Pl Nw, Atlanta, GA 30318-6364 | 2018-06-11 |
| 1841708682 | Aica Orthopedics, P.C. | Clinic/Center | 2045 Peachtree Rd Ne Ste 700, Atlanta, GA 30309-1417 | 2018-01-15 |
| 1407361702 | Buckhead Cosmetic and Family Dentistry LLC | Clinic/Center | 316 Pharr Rd Ne, Atlanta, GA 30305-2304 | 2017-12-08 |
| 1366952749 | Cancer Screening of America | Clinic/Center | 1 Baltimore Pl Nw Ste 240, Atlanta, GA 30308-2116 | 2017-10-11 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.