LIFESOURCE OF GEORGIA
NPI 1962940817
General Practice in Rome, GA

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: October 25, 2026.

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

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
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

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

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 Of Georgia is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

92

Medicare enrollment records show 92 clinicians reassign Medicare billing to Lifesource Of Georgia, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 8 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 6

Nurse Practitioner37
Clinical Social Worker26
Mental Health Counselor19
Psychiatry5
Clinical Psychologist4
Family Practice1

Nearest to this location (20)

See all 92
Clinical Social Worker
NPI 1437100484
1345 REDMOND CIR NW
Rome, GA 30165
(910) 742-9243
✔ PECOSSame address
Clinical Social Worker
NPI 1962121988
1345 REDMOND CIR NW
Rome, GA 30165
(910) 742-9243
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1669801551
1345 REDMOND CIR NW
Rome, GA 30165
(910) 742-9243
✔ PECOS✔ Accepts MedicareSame address
Clinical Social Worker
NPI 1003503756
1345 REDMOND CIR NW
Rome, GA 30165
(910) 742-9243
✔ PECOS✔ Accepts MedicareSame address
Clinical Social Worker
NPI 1417217092
1345 REDMOND CIR NW
Rome, GA 30165
(910) 742-9243
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1023701307
1345 REDMOND CIR NW
Rome, GA 30165
(910) 742-9243
✔ PECOS✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1811328347
134 REDMOND CIRCLE NW
Rome, GA 30165
(910) 742-9243
✔ PECOS✔ Accepts Medicare1.1 mi
Mental Health Counselor
NPI 1437905221
332 HASTY RD NE
Rome, GA 30161
(762) 357-4921
✔ PECOS✔ Accepts Medicare5.6 mi
Nurse Practitioner
NPI 1053035725
4775 PASTRY LN # 227
Acworth, GA 30101
(678) 357-8171
✔ PECOS✔ Accepts Medicare35 mi
Nurse Practitioner
NPI 1346871696
108 CRESCENT WOODE DR
Dallas, GA 30157
(770) 702-5945
✔ PECOS36 mi
Clinical Social Worker
NPI 1669747267
1539 HAVEN CREST DR POWDER SPRINGS
Powder Springs, GA 30127
(317) 989-7370
✔ PECOS38 mi
Nurse Practitioner
NPI 1942783477
3061 STAGLIN DR
Powder Springs, GA 30127
(404) 444-7502
✔ PECOS42 mi
Psychiatry
NPI 1083870265
101 QUARTZ DR STE 103
Villa Rica, GA 30180
(770) 812-3530
✔ PECOS✔ Accepts Medicare42 mi
Mental Health Counselor
NPI 1316551484
3133 GOLF RIDGE BLVD STE 304
Douglasville, GA 30135
(470) 526-8043
✔ PECOS✔ Accepts Medicare48 mi
Clinical Social Worker
NPI 1205297090
4085 CRABAPPLE LAKE CT
Roswell, GA 30076
(770) 825-3792
✔ PECOS✔ Accepts Medicare50 mi
Mental Health Counselor
NPI 1386212579
500 SUN VALLEY DR STE G3
Roswell, GA 30076
(770) 910-9162
✔ PECOS✔ Accepts Medicare52 mi
Psychiatry
NPI 1831375682
3333 OLD MILTON PKWY STE 160
Alpharetta, GA 30005
(678) 335-6020
✔ PECOS✔ Accepts Medicare56 mi
Clinical Psychologist
NPI 1437612322
9757 BLUE RIDGE DR
Blue Ridge, GA 30513
(706) 455-2490
✔ PECOS✔ Accepts Medicare65 mi
Clinical Psychologist
NPI 1821140237
4177 RAINBOW DR
Decatur, GA 30034
(855) 772-8847
✔ PECOS69 mi
Family Practice
NPI 1659758175
65 OLD JACKSON RD
Mcdonough, GA 30252
(678) 490-0080
✔ PECOS✔ Accepts Medicare87 mi
See all 92 clinicians

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 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.

Where is Lifesource Of North Carolina located?

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

What is Lifesource Of North Carolina's specialty?

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

Is Lifesource Of North Carolina enrolled in Medicare?

Yes. Lifesource Of North Carolina is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lifesource Of North Carolina?

According to the CMS Revalidation Reassignment List (October 2026 release), 92 clinicians in 6 Medicare specialties reassign their Medicare billing to Lifesource Of North Carolina. 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. The largest specialties are Nurse Practitioner (37), Clinical Social Worker (26) and Mental Health Counselor (19). Of these, 6 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lifesource Of North Carolina accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Lifesource Of North Carolina as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lifesource Of North Carolina was last updated on March 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.