LIFE CYCLE PEDIATRICS, LLC (NPI# 1508363128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508363128 |
| Entity Type | Organization |
| Organization Name | LIFE CYCLE PEDIATRICS, LLC |
| Practice Address |
428 Winn Ct Ste 100a Decatur GA 30030-1726 |
| Practice Telephone | 4042280601 |
| Practice Fax Number | 4706982141 |
| Mailing Telephone | 4042280601 |
| Mailing Fax Number | 4706982141 |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |
| Authorized Official Name | GWENDOLYN WILLIAMS (OFFICE MANAGER) |
| Authorized Official Telephone | 4042280601 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 894980142A | 05 | |
| GA | 894980142D | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134331952 | Life Cycle Pediatrics, LLC | Pediatrics | 2739 Felton Dr, East Point, GA 30344-3603 | 2007-05-04 |
| Street Address |
428 WINN CT STE 100A |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-1726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003465162 | Emily Rhoades | Pediatrics | 637 E Snyder Dr, Decatur, IL 62526-4766 | 2019-09-10 |
| 1477013720 | Decatur Morgan Pediatrics | Pediatrics | 1215 7th St Se Ste 210, Decatur, AL 35601-3385 | 2019-03-22 |
| 1063956902 | Anna Bowen | Pediatrics | 128 Fairview Ave, Decatur, GA 30030-2416 | 2016-12-12 |
| 1780057042 | William Walker | Pediatrics | 1561 Blackhall Ln Se, Decatur, AL 35601-6917 | 2015-11-09 |
| 1336542240 | Eva Harris | Pediatrics | 2613 Danforth Ln, Decatur, GA 30033-2214 | 2014-10-06 |
| 1750796967 | Sugantha Krishnan | Pediatrics | 1201 7th St Se Ste 210, Decatur, AL 35601-3337 | 2014-06-25 |
| 1093158370 | Ruth Wessen Stefanos | Pediatrics | 609 Medical Center Dr # 2218, Decatur, TX 76234-3836 | 2013-04-17 |
| 1265772917 | William Jennings Branan Jr. | Pediatrics | 2592 River Oak Drive, Decatur, GA 30033 | 2013-02-18 |
| 1245576115 | Sharmila Shetty | Pediatrics | 446 Woodhaven Dr, Decatur, GA 30030-1650 | 2012-12-21 |
| 1356616429 | Jennifer Lynn Menon | Pediatrics | 1874 Beltline Rd Sw Ste 300, Decatur, AL 35601-5514 | 2012-03-21 |
| Find all providers in DECATUR | ||||
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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.