LIFESOURCE OF GEORGIA
NPI 1962940817
General Practice in Rome, GA

Q: What is Lifesource Of North Carolina's NPI number?

The NPI number for Lifesource Of North Carolina is 1962940817. It was assigned to this organization in the NPPES registry on February 10, 2017. The provider is doing business as Lifesource Of Georgia.

Q: What is Lifesource Of North Carolina's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since February 10, 2017

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

NPPES record last updated: March 26, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 26, 2021, Jul 5, 2019, May 22, 2018 and 3 more (6 updates tracked since 2017).

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About Lifesource Of Georgia NPPES

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

LIFESOURCE OF GEORGIA (NPI 1962940817) is a healthcare organization registered as a general practice in Rome, Georgia and active in the NPI registry since February 2017. The organization lists Peggy L Baddour, President, as its authorized official.

NPPES Registry Identity

NPI1962940817

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameLIFESOURCE OF NORTH CAROLINA

Location Address1345 REDMOND CIR NWRome, GA 30165-1307

Mailing AddressPo Box 538622Atlanta, GA 30353-8622 · (910) 535-1211

Phone(910) 742-9243

Fax(888) 746-1787

Organization SubpartYes

Authorized OfficialPeggy L BaddourPresident · (910) 777-9165

Enumeration DateFebruary 10, 2017

Last NPPES UpdateMarch 26, 20216 updates tracked since enumeration

NPPES CertifiedMarch 26, 2021

✔ NPI 1962940817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedPsychologistTaxonomy 103T00000X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

1345 REDMOND CIR NW, Rome, GA 30165

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Other Names 1

Doing Business AsLifesource Of Georgia

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 Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLA LIVINGSTON LANE PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)