Lifesource Prime Inc
NPI 1841155181ActiveOrganization· Internal Medicine· Rome, GA
Internal Medicine in Rome, Georgia, registered in NPPES in December 2025. The authorized official on file is Tabitha Hoffman, Credentialing. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1841155181 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 18, 2025 |
| Last updated in NPPES | Dec 18, 2025 |
| Certified by provider | Dec 18, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
| Physician Assistant | 363A00000X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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