LIFE SOURCE OF CENTERVILLE – NPI #1366957656
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).
LIFE SOURCE OF CENTERVILLE is an AHC clinic located in CENTERVILLE, TN. NPPES has assigned the NPI number 1366957656 to LIFE SOURCE OF CENTERVILLE on December 07, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LIFE SOURCE OF CENTERVILLE” is a dba name, the actual legal business name for this organization is ROBERT WILSON, DC, PLLC. The primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.
The NPI profile was previously updated about 8 years ago on Jun 11, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LIFE SOURCE OF CENTERVILLE below.
NPI Profile for
ROBERT WILSON, DC, PLLC
(more than 8 years ago)
CENTERVILLE, TN 37033 Phone: (931) 729-4001 Fax: (931) 729-4081
CENTERVILLE, TN 37033-0099 Phone: (931) 729-4001 Fax: (931) 729-4081
SOLE OWNER
Phone: (931) 729-4001
Identifiers for LIFE SOURCE OF CENTERVILLE
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| OTHER | BLUE CROSS BLUE SHIED OF TENNESSEE | 6128617 | |
| OTHER | NPPES - INDIVIDUAL NPI | 1144589458 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 261Q00000X - Clinic/Center (Primary) |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.