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LIFEPLEX FAMILY PRACTICE
NPI 1114449238
Family Medicine in Plymouth, IN

Active since July 11, 2017CLIA 15D2297475 · Waiver
2855 MILLER DR STE 117, PLYMOUTH, IN 46563(574) 936-7777(574) 941-1072 Get Directions Write a Review

NPPES record last updated: May 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 25, 2021, Mar 17, 2018, Jul 11, 2017 (3 updates tracked since 2017).

About Lifeplex Family Practice NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFEPLEX FAMILY PRACTICE (NPI 1114449238) is a healthcare organization registered as a family medicine in Plymouth, Indiana and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through January 16, 2028, maintains 2 additional practice locations, and lists Byron Holm, Md, as its authorized official.

NPPES Registry Identity

NPI1114449238
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLIFEPLEX MEDICAL INC
Location Address2855 MILLER DR STE 117Plymouth, IN 46563-8091
Mailing Address2855 Miller Dr Ste 117Plymouth, IN 46563-8091 · (574) 936-7777 · Fax (574) 941-1072
Phone(574) 936-7777
Fax(574) 941-1072
Organization SubpartNo
Authorized OfficialByron HolmMd · (574) 936-7777
Enumeration DateJuly 11, 2017
Last NPPES UpdateMay 25, 20213 updates tracked since enumeration
NPPES CertifiedMay 25, 2021
✔ NPI 1114449238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01024911A
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
2855 MILLER DR STE 117, Plymouth, IN 46563
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Other Names 1

Doing Business AsLifeplex Family Practice

Secondary Practice Locations 2

Location 12855 Miller Dr Ste 119Plymouth, IN 46563-8091 · Phone (574) 941-1000 · Fax (574) 941-1075
Location 2506 Michigan StWalkerton, IN 46574-1116 · Phone (574) 936-7777 · Fax (574) 941-1072

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 15D2297475

Lifeplex Medical, Inc · Plymouth, IN
Active · expires Jan 16, 2028
CLIA Number15D2297475
Laboratory TypePhysician Office
Certificate Effective DateJanuary 17, 2026
Certificate Expiration DateJanuary 16, 2028
Laboratory DirectorLisa L. Jones
Laboratory Phone(574) 936-7777
Laboratory LocationLifeplex Medical, Inc2855 Miller Dr, Suite 107, Plymouth, IN 46563
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN R GROLICH BA
Emergency Medical Technician, Basic
2855 MILLER DR STE 117
PLYMOUTH, IN 46563
Marshall County (574) 936-7777
JEANA RENEE BERGER MSN, FNP-C
Nurse Practitioner (Primary Care)
2855 MILLER DR STE 117
PLYMOUTH, IN 46563
Marshall County (574) 316-8010

Frequently 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 Lifeplex Medical Inc's NPI number?

The NPI number for Lifeplex Medical Inc is 1114449238. It was assigned to this organization in the NPPES registry on July 11, 2017. The provider is doing business as Lifeplex Family Practice.

Where is Lifeplex Medical Inc located?

Lifeplex Medical Inc is located at 2855 Miller Dr Ste 117, Plymouth, IN 46563. The listed phone number is (574) 936-7777.

What is Lifeplex Medical Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Lifeplex Medical Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2297475) is associated with this NPI, valid through January 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lifeplex Medical Inc accept?

Health plans from CareSource list Lifeplex Medical Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lifeplex Medical Inc was last updated on May 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.