LIFEGUARD MEDICAL GROUP, LLC
NPI 1548436538
Emergency Medicine in Chilmark, MA
- Organization
- Emergency Medicine
- CLIA Number: 22D1097315
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-23-2027
About LIFEGUARD MEDICAL GROUP, LLC
This page provides the complete NPI Profile along with additional information for Lifeguard Medical Group, Llc, a provider established in Chilmark, Massachusetts operating as a Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1548436538 assigned on April 2008. The practitioner's primary taxonomy code is 207P00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Lifeguard Medical Group, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Jeffrey R Zack Md (Manager)
- NPI
- 1548436538 Verify this NPI
- Provider Name
- LIFEGUARD MEDICAL GROUP, LLC
- Entity Type
- Organization
- Location Address
- 45 BLUE BARQUE RD CHILMARK, MA 02535
- Location Phone
- (508) 696-6863
- Location Fax
- (508) 696-6864
- Mailing Address
- PO BOX 1356 OAK BLUFFS, MA 02557
- Mailing Phone
- (508) 696-6863
- Mailing Fax
- (508) 696-6864
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-30-2008
- Last Update Date
- 05-10-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 22D1097315
- Facility Type
- Physician Office
- Certificate Effective Date
- March 24, 2025
- Certificate Expiration Date
- March 23, 2027
- Laboratory Director
- JEFFREY ZACK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lifeguard Medical Group, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1548436538, enumerated as an "organization" on April 30, 2008.
The provider is located at 45 BLUE BARQUE RD CHILMARK, MA 02535 and the phone number is (508) 696-6863.
Emergency Medicine with taxonomy code 207P00000X.
