LIFESOURCE OF NORTH CAROLINA
NPI 1972861789
General Practice in Clinton, SC

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

The NPI number for Lifesource Of North Carolina is 1972861789. It was assigned to this organization in the NPPES registry on April 30, 2012.

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 April 30, 2012

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

NPPES record last updated: May 17, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 17, 2022, Mar 26, 2021, Apr 24, 2018 (3 updates tracked since 2018).

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About Lifesource Of North Carolina NPPES

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

LIFESOURCE OF NORTH CAROLINA (NPI 1972861789) is a healthcare organization registered as a general practice in Clinton, South Carolina and active in the NPI registry since April 2012. The organization maintains a secondary practice location in Chapin and lists Peggy L Baddour, President/owner, as its authorized official.

NPPES Registry Identity

NPI1972861789

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameLIFESOURCE OF NORTH CAROLINA

Location Address939 SPRINGDALE DRClinton, SC 29325-7266

Mailing AddressPo Box 538622Atlanta, GA 30353-8622 · (910) 742-9243 · Fax (888) 746-1787

Phone(910) 742-9243

Organization SubpartNo

Authorized OfficialPeggy L BaddourPresident/owner · (910) 777-9165

Enumeration DateApril 30, 2012

Last NPPES UpdateMay 17, 20223 updates tracked since enumeration

NPPES CertifiedMay 17, 2022

✔ NPI 1972861789 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 ListedPsychologist · ClinicalTaxonomy 103TC0700X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

939 SPRINGDALE DR, Clinton, SC 29325

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Secondary Practice Location 1

Location 12101 Dutch Fork RdChapin, SC 29036-7576 · Phone (910) 742-9243 · Fax (888) 746-1787

Other Identifiers 1

MedicaidGP5917SC

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 of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

Other Providers at the Same Location NPPES 10

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

CATHERINE M KEARON PMHNP

Nurse Practitioner (Psychiatric/Mental Health)