LIFESTYLE PAIN MANAGEMENT AND WELLNESS CENTER, PC (NPI# 1417573114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417573114 |
| Entity Type | Organization |
| Organization Name | LIFESTYLE PAIN MANAGEMENT AND WELLNESS CENTER, PC |
| Practice Address |
1982 Main St E Ste C Snellville GA 30078-6461 |
| Practice Telephone | 4703953618 |
| Practice Fax Number | 7709795155 |
| Mailing Telephone | 4703953618 |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2020-06-19 |
| Authorized Official Name | BELINDA MILLINGTON (CEO) |
| Authorized Official Telephone | 4703953618 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | LICENSE NUMBER | 66224 | 01 |
| Street Address |
1982 MAIN ST E STE C |
| City | SNELLVILLE |
| State | GA |
| Zip Code | 30078-6461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780120188 | Mountaintop Healthcare Co | Clinic/Center | 1982 Main St E Ste C, Snellville, GA 30078-6461 | 2017-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619594561 | Steven Nguyen | Optometrist | 1905 Scenic Hwy S #1130, Snellville, GA 30078 | 2020-06-26 |
| 1891320776 | Youstina Harkas | Optometrist | 1679 Scenic Hwy S 203, Snellville, GA 30078 | 2020-03-11 |
| 1578101127 | Jwwt Neuoromonitoring, LLC | Psychiatry & Neurology | 1350 Scenic Highway, Suite 266, Snelville, GA 30078 | 2019-12-13 |
| 1679119903 | Lashon Poole Wells | Social Worker | 1350 Scenic Highway Ste 266, 1350 Scenic Highway Ste 266, Snellville, GA 30078 | 2019-11-21 |
| 1427601426 | Aemad Heavenly Joy Senior Homecare & Developmental Disabilities LLC | Registered Nurse | 1350 Scenic Highway Suite #266, Sneville, GA 30078 | 2019-07-18 |
| 1063975548 | Joanne Mcdougal Patterson | Nurse Practitioner | 1350 Scenic Hwy N Ste 226, Snellville, GA 30078 | 2019-04-10 |
| 1689144263 | Israel Branford | Physical Therapist | 1575 Scenic Hwy Ste 100, Snellville, GA 30078 | 2018-11-27 |
| 1902382997 | Brittany Dupree | Dermatology | 2383 Pate Street North, Snellville, GA 30078 | 2018-07-13 |
| 1134610926 | Reid Weston Popple | Dentist | 2992 Stone Mountain Hwy, A100, Snellville, GA 30078 | 2018-05-29 |
| 1326550492 | Optimal Healthcare Services LLC | Clinic/Center | 2121 Fountain Dr Ste F, Snellville, GA 30078 | 2017-10-30 |
| Find all providers in zip 30078 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970640 | Fx Spine and Performance Center, LLC | Clinic/Center | 106 Srp Dr Ste B, Evans, GA 30809-4358 | 2020-07-24 |
| 1083253140 | Intercare Medical, Corp | Clinic/Center | 3540 Wheeler Rd Ste 307, Augusta, GA 30909-1887 | 2020-01-06 |
| 1346763190 | Laser Spine & Pain Centers LLC | Clinic/Center | 403 Permian Way Ste C, Villa Rica, GA 30180-3252 | 2017-07-24 |
| 1164828976 | Atlanta Pain and Wellness Center PC | Clinic/Center | 1287 Ga Hwy 138 Spur Ste 8, Jonesboro, GA 30236-2419 | 2014-11-06 |
| 1790031664 | Nr Medical Center, LLC | Clinic/Center | 213 Arrowhead Blvd, Suite D, Jonesboro, GA 30236-1168 | 2012-07-30 |
| 1740566181 | Physical Medicine of Norcross | Clinic/Center | 6315 Spaulding Dr Ste B, Norcross, GA 30092-4653 | 2011-10-31 |
| 1407131899 | Cambridge Labs,llc | Clinic/Center | 611 15th St, Augusta, GA 30901-2601 | 2011-10-17 |
| 1043537905 | Primacare Pain & Rehab.,llc | Clinic/Center | 4467 Glenwood Rd, Suite 2, Decatur, GA 30032-5014 | 2010-04-30 |
| 1194994244 | Ernie E Lin | Clinic/Center | 211 Pleasant Home Road, Suite F-3, Augusta, GA 30907-0559 | 2008-02-22 |
| 1235354218 | Acworth Pain Management Center Inc | Clinic/Center | 5399 Bells Ferry Rd, Suite 180, Acworth, GA 30102-7546 | 2007-04-16 |
| Find all providers with the same taxonomy | ||||
| City | SNELLVILLE |
| Zip Code | 30078 |
Please comment or provide details below to improve the information on LIFESTYLE PAIN MANAGEMENT AND WELLNESS CENTER, PC.
| 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.