LIFE UNIVERSITY (NPI# 1700408887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700408887 |
| Entity Type | Organization |
| Organization Name | LIFE UNIVERSITY |
| Practice Address |
1323 Roswell Road Marietta GA 30062 |
| Practice Telephone | 7704262946 |
| Mailing Telephone | 7704262946 |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2020-05-12 |
| Authorized Official Name | WILLIAM S JARR (EXECUTIVE VICE PRESIDENT -FINANCE) |
| Authorized Official Telephone | 7704262623 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Life Chiropractic Centers-Roswell | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063033942 | Life University | Chiropractor | 1 Baltimore P1. Nw, Suite 100, Atlanta, GA 30308 | 2020-05-01 |
| 1780082404 | Life University | Clinic/Center | 1415 Barclay Cir Se, Marietta, GA 30060-2943 | 2014-12-11 |
| 1902033343 | Life University | Clinic/Center | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2009-06-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | LIFE UNIVERSITY | 655 Nw 195th St, Shoreline, WA 30060-2673 |
| Street Address |
1323 ROSWELL ROAD |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| 1396100111 | Lisa Marie Walsh | Nurse Practitioner | 4343 Shallowford Rd Ste B7b, Marietta, GA 30062 | 2015-12-21 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295382778 | Advanced Urology Institute of Georgia | Clinic/Center | 1371 Church Street Ext Ne Ste 200, Marietta, GA 30060-7913 | 2019-08-20 |
| 1699259929 | Life Moves Manual Therapies, LLC | Clinic/Center | 1800 Roswell Rd Ste 1050, Marietta, GA 30062-3982 | 2018-09-21 |
| 1972091460 | Neuroworks Healthcare LLC | Clinic/Center | 3939 Roswell Rd Ste 240, Marietta, GA 30062-6285 | 2018-04-30 |
| 1053862169 | Regional Marietta Medical Center | Clinic/Center | 1469 Roswell Rd, Marietta, GA 30062-3668 | 2016-10-24 |
| 1821402348 | Washington County Free Clinic Inc | Clinic/Center | 208 3rd St, Marietta, OH 45750-3001 | 2014-06-12 |
| 1851638464 | L & P Services Inc | Clinic/Center | 215 Marion St, Marietta, OH 45750-1842 | 2013-01-16 |
| 1578703773 | Hyperbaric Medicine of North Atlanta | Clinic/Center | 1341 Canton Rd, Suite A, Marietta, GA 30066-6056 | 2009-02-27 |
| 1699920983 | Dr. Biggs Chiropractic, Inc. | Clinic/Center | 736 Johnson Ferry Rd., Suite -c130, Marietta, GA 30068-4233 | 2008-12-01 |
| 1538246251 | Urology Associates Surgical Center | Clinic/Center | 300 Tower Rd, Suite 150, Marietta, GA 30060 | 2006-11-01 |
| 1285727396 | The Family Health Centers of Georgia, Inc | Clinic/Center | 805 Campbell Hill St Nw, Marietta, GA 30060-1144 | 2006-10-02 |
| Find all providers in MARIETTA | ||||
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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.