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LIFESOURCE OF NORTH CAROLINA NPI 1811286156


NPI Information

NPI: 1811286156
Provider Name: LIFESOURCE OF NORTH CAROLINA
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
3205 RANDALL PKWY
SUITE 105
WILMINGTON, NC
ZIP 28403
Phone: (910) 742-9243
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LIFESOURCE OF NORTH CAROLINA is an internal medicine in Wilmington, NC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. LIFESOURCE OF NORTH CAROLINA NPI is 1811286156. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3205 RANDALL PKWY
SUITE 105
WILMINGTON, NC
ZIP 28403
Phone: (910) 742-9243
Fax: (888) 746-1787

The provider's authorized official is Peggy L Baddour .
The authorized official title is President/owner and has the following contact phone number (910) 777-9165.

The enumeration date for this NPI number is 4/6/2011 and was last updated on 12/29/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalNo
21041C0700XSocial WorkerClinicalNo
3207Q00000XFamily MedicineNo
4207R00000XInternal MedicineYes
52084P0800XPsychiatry & NeurologyPsychiatryNo
6363A00000XPhysician AssistantNo
7363L00000XNurse PractitionerNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.