LIFEGATE HEALTH & WELLNESS (NPI# 1508481862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508481862 |
| Entity Type | Organization |
| Organization Name | LIFEGATE HEALTH & WELLNESS |
| Practice Address |
3784 Harris Blvd Nw Kennesaw GA 30144-6098 |
| Practice Telephone | 9547707059 |
| Mailing Telephone | 9547707059 |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-06-12 |
| Authorized Official Name | EMMANUELLE CHASSAGNE (OWNER) |
| Authorized Official Telephone | 9547707059 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFEGATE HEALTH & WELLNESS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 302R00000X | Health Maintenance Organization | Managed Care Organizations | ||
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3784 HARRIS BLVD NW |
| City | KENNESAW |
| State | GA |
| Zip Code | 30144-6098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
| 1033632203 | Octavio Andres Tobar | Specialist/Technologist | 1950 Barrett Lakes Blvd Nw Apt 1213, Kennesaw, GA 30144 | 2017-07-19 |
| 1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
| 1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
| 1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
| 1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
| 1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
| 1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
| 1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
| Find all providers in zip 30144 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639784788 | Natasha Allen | Nurse Practitioner | 4177 Pelham Cir, Lithonia, GA 30038-6140 | 2020-09-14 |
| 1336753920 | Henny P Brown | Nurse Practitioner | 3430 Ridgeland Pl, Alpharetta, GA 30004-8483 | 2020-09-01 |
| 1487267415 | Alethea Hope Tucker | Nurse Practitioner | 3685 Braselton Hwy Ste 100, Dacula, GA 30019-5920 | 2020-08-28 |
| 1952913808 | Carol Jo Wilbanks | Nurse Practitioner | 206 Crest Dr, Rock Spring, GA 30739-2041 | 2020-08-21 |
| 1164032017 | Myiesha Sellers Mcfarlin | Nurse Practitioner | 55 Sellers Ln, Baxley, GA 31513-2208 | 2020-08-05 |
| 1124645395 | Kisha Smalley | Nurse Practitioner | 117 Gambier Cv, Mcdonough, GA 30252-6273 | 2020-07-02 |
| 1346861127 | Finan Tedla | Nurse Practitioner | 2626 Peachtree Rd Nw Unit 1802, Atlanta, GA 30305-5633 | 2020-05-03 |
| 1841819547 | Millicent Charte Duncan | Nurse Practitioner | 138 Parkview Rd, Savannah, GA 31419-9672 | 2020-04-13 |
| 1891329660 | Tracey Lynn Murray | Nurse Practitioner | 980 Johnson Ferry Rd Ste 880, Sandy Springs, GA 30342-1609 | 2020-03-02 |
| 1841820917 | Vedic Family Practice and Wellness | Nurse Practitioner | 1240 Upper Hembree Rd Ste E, Roswell, GA 30076-0914 | 2020-01-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.