LIFE SPAN WELLNESS LLC
NPI 1356036529
Nurse Practitioner - Psychiatric/Mental Health in Bloomfield, NJ
About Life Span Wellness Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LIFE SPAN WELLNESS LLC (NPI 1356036529) is a healthcare organization registered as a psychiatric/mental health in Bloomfield, New Jersey and active in the NPI registry since April 2023. The organization lists Abiodun Akinola Olatubosun, Apn, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 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)
Life Span Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Life Span Wellness LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Life Span Wellness LLC's NPI number?
The NPI number for Life Span Wellness LLC is 1356036529. It was assigned to this organization in the NPPES registry on April 5, 2023.
Where is Life Span Wellness LLC located?
Life Span Wellness LLC is located at 156 Baldwin Pl, Bloomfield, NJ 07003. The listed phone number is (862) 220-0914.
What is Life Span Wellness LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Life Span Wellness LLC enrolled in Medicare?
Yes. Life Span Wellness LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Life Span Wellness LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Life Span Wellness 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Life Span Wellness LLC was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 days 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.
# Life Span Wellness Llc · NPI 1356036529
Psychiatric/Mental Health organization in Bloomfield, New Jersey. Organization record, active in the CMS NPPES registry since April 5, 2023.
## Identity
- **NPI:** 1356036529 (Entity type: Organization)
- **Enumerated:** April 5, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Abiodun Olatubosun, APN
## Practice location
- **Address:** 156 BALDWIN PL, Bloomfield, NJ 07003-6036
- **Phone:** (862) 220-0914 · **Fax:** (862) 306-1037
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 26, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1356036529) · Data from the CMS NPPES public registry.