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LIFESOURCE PRIME INC
NPI 1841155181
Internal Medicine in Rome, GA

Active since December 18, 2025
1345 REDMOND CIR NW, ROME, GA 30165(910) 742-9243(888) 746-1787 Get Directions Write a Review

NPPES record last updated: December 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lifesource Prime Inc NPPES

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

LIFESOURCE PRIME INC (NPI 1841155181) is a healthcare organization registered as an internal medicine in Rome, Georgia and active in the NPI registry since December 2025. The organization lists Tabitha Hoffman, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1841155181
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLIFESOURCE PRIME INC
Location Address1345 REDMOND CIR NWRome, GA 30165-1307
Mailing AddressPo Box 740343Atlanta, GA 30374-0343 · (910) 742-9243 · Fax (888) 746-1787
Phone(910) 742-9243
Fax(888) 746-1787
Organization SubpartNo
Authorized OfficialTabitha HoffmanCredentialing · (910) 777-9165
Enumeration DateDecember 18, 2025
NPPES CertifiedDecember 18, 2025
✔ NPI 1841155181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
1345 REDMOND CIR NW, Rome, GA 30165
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lifesource Prime Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Lifesource Prime Inc, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Aigul Guilmanova, MD
Family Practice
NPI 1659758175
65 OLD JACKSON RD
Mcdonough, GA 30252
(678) 490-0080
✔ PECOS✔ Accepts Medicare87 mi
Tiffany Griffin, APRN
Nurse Practitioner
NPI 1417648916
SC HOUSE CALLS INC 111 DOCTORS CIRCLE
Columbia, SC 29203
(800) 491-0909
✔ PECOS✔ Accepts Medicare239 mi

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 Lifesource Prime Inc's NPI number?

The NPI number for Lifesource Prime Inc is 1841155181. It was assigned to this organization in the NPPES registry on December 18, 2025.

Where is Lifesource Prime Inc located?

Lifesource Prime Inc is located at 1345 Redmond Cir NW, Rome, GA 30165. The listed phone number is (910) 742-9243.

What is Lifesource Prime Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Lifesource Prime Inc enrolled in Medicare?

Yes. Lifesource Prime Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lifesource Prime Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Lifesource Prime Inc, in Family Practice and Nurse Practitioner. 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 Lifesource Prime Inc was last updated on December 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.