LIFETIME FAMILY MEDICINE LLC
NPI 1053509216
Family Medicine in Dallas, GA
About Lifetime Family Medicine Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LIFETIME FAMILY MEDICINE LLC (NPI 1053509216) is a healthcare organization registered as a family medicine in Dallas, Georgia and active in the NPI registry since October 2007. The organization holds 2 active CLIA laboratory certificates and lists Lisa H Miles, Practice Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lifetime Family Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Lifetime Family Medicine LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D1076786
Lifetime Family Medicine · Dallas, GACertificate of Waiver 11D2153477
Lifetime Family Medicine · Temple, GAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Lifetime Family Medicine,llc's NPI number?
The NPI number for Lifetime Family Medicine,llc is 1053509216. It was assigned to this organization in the NPPES registry on October 11, 2007. The provider is doing business as Lifetime Family Medicine LLC.
Where is Lifetime Family Medicine,llc located?
Lifetime Family Medicine,llc is located at 7869 Villa Rica Hwy, Dallas, GA 30157. The listed phone number is (770) 459-8449.
What is Lifetime Family Medicine,llc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Lifetime Family Medicine,llc enrolled in Medicare?
Yes. Lifetime Family Medicine,llc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lifetime Family Medicine,llc?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Lifetime Family Medicine,llc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4) and Family Practice (2). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Lifetime Family Medicine,llc hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Lifetime Family Medicine,llc was last updated on March 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lifetime Family Medicine Llc · NPI 1053509216
Family Medicine organization in Dallas, Georgia. Organization record, active in the CMS NPPES registry since October 11, 2007.
## Identity
- **NPI:** 1053509216 (Entity type: Organization)
- **Enumerated:** October 11, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Lifetime Family Medicine,llc
- **Organization subpart:** No
- **Authorized official:** Lisa Miles, PRACTICE MANAGER
## Practice location
- **Address:** 7869 VILLA RICA HWY, Dallas, GA 30157-8638
- **Phone:** (770) 459-8449
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (4), Family Practice (2); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 10, 2023
- **CLIA laboratory certificates:** 2 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1053509216) · Data from the CMS NPPES public registry.