LIFESOURCE PRIME INC
NPI 1851143523
Family Medicine in Clinton, SC

Q: What is Lifesource Prime Inc's NPI number?

The NPI number for Lifesource Prime Inc is 1851143523. It was assigned to this organization in the NPPES registry on April 4, 2024.

Q: What is Lifesource Prime Inc's specialty?

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

Active since April 04, 2024

939 SPRINGDALE DR, CLINTON, SC 29325(910) 742-9243(888) 746-1787 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 10, 2025, Apr 4, 2024 (2 updates tracked since 2024).

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About Lifesource Prime Inc NPPES

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

LIFESOURCE PRIME INC (NPI 1851143523) is a healthcare organization registered as a family medicine in Clinton, South Carolina and active in the NPI registry since April 2024. The organization lists Peggy Baddour, President/owner, as its authorized official.

NPPES Registry Identity

NPI1851143523

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameLIFESOURCE PRIME INC

Location Address939 SPRINGDALE DRClinton, SC 29325-7266

Mailing AddressPo Box 740343Atlanta, GA 30374-0343 · (910) 338-2885 · Fax (864) 626-0412

Phone(910) 742-9243

Fax(888) 746-1787

Organization SubpartNo

Authorized OfficialPeggy BaddourPresident/owner · (910) 742-9243

Enumeration DateApril 4, 2024

Last NPPES UpdateOctober 28, 20252 updates tracked since enumeration

NPPES CertifiedOctober 28, 2025

✔ NPI 1851143523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

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 ListedInternal MedicineTaxonomy 207R00000X

Also ListedGeneral PracticeTaxonomy 208D00000X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X

939 SPRINGDALE DR, Clinton, SC 29325

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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, Molina Healthcare.Insurance ›

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

Medicare enrollment records show 29 clinicians reassign Medicare billing to Lifesource Prime Inc, which bills Medicare for the services they deliver. Of these, 6 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Nurse Practitioner24

Internal Medicine3

Family Practice2

Nearest to this location (20)

See all 29

Vivian Breslin, NURSE PRACTITIONER

Nurse Practitioner

NPI 1356434955