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LIVE OAK ALLERGY, ASTHMA & IMMUNOLOGY, LLC
NPI 1689066649
Clinic/Center - Medical Specialty in Pooler, GA

Active since February 28, 2015
143 CANAL ST, SUITE 200, POOLER, GA 31322(615) 477-2226 Get Directions Write a Review

NPPES record last updated: February 28, 2015. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Live Oak Allergy, Asthma & Immunology, Llc NPPES

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

LIVE OAK ALLERGY, ASTHMA & IMMUNOLOGY, LLC (NPI 1689066649) is a healthcare organization registered as a medical specialty in Pooler, Georgia and active in the NPI registry since February 2015. The organization lists Mitchell Dewayne Henson, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1689066649
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameLIVE OAK ALLERGY, ASTHMA & IMMUNOLOGY, LLC
Location Address143 CANAL ST, SUITE 200Pooler, GA 31322-6007
Mailing Address143 Canal St, Suite 200Pooler, GA 31322-6007
Phone(615) 477-2226
Organization SubpartNo
Authorized OfficialMitchell Dewayne HensonPractice Manager · (615) 477-4321
Enumeration DateFebruary 28, 2015
✔ NPI 1689066649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in GA · 073306
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
143 CANAL ST, Pooler, GA 31322
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Live Oak Allergy, Asthma & Immunology, 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 Live Oak Allergy, Asthma & Immunology, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Michele Henson, MD
Allergy/Immunology
NPI 1306993126
143 CANAL STREET SUITE 200
Pooler, GA 31322
(912) 348-4100
✔ PECOS✔ Accepts MedicareSame address

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 Live Oak Allergy, Asthma & Immunology, LLC's NPI number?

The NPI number for Live Oak Allergy, Asthma & Immunology, LLC is 1689066649. It was assigned to this organization in the NPPES registry on February 28, 2015.

Where is Live Oak Allergy, Asthma & Immunology, LLC located?

Live Oak Allergy, Asthma & Immunology, LLC is located at 143 Canal St Suite 200, Pooler, GA 31322. The listed phone number is (615) 477-2226.

What is Live Oak Allergy, Asthma & Immunology, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is Live Oak Allergy, Asthma & Immunology, LLC enrolled in Medicare?

Yes. Live Oak Allergy, Asthma & Immunology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Live Oak Allergy, Asthma & Immunology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Allergy/Immunology) reassigns their Medicare billing to Live Oak Allergy, Asthma & Immunology, 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 Live Oak Allergy, Asthma & Immunology, LLC was last updated on February 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.