Mentorup Life Lab & Clinic
NPI 1063104511 · General Practice Physician · Tuscaloosa, AL
Mentorup Life Lab & Clinic is a General Practice Physician organization in Tuscaloosa, AL (NPI 1063104511).
Provider details
- NPI number
- 1063104511
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ellory Johnson, Medical Director(205) 771-2261
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-05-23
- Last updated
- 2023-05-23
- Certified
- 2023-05-23
Frequently asked questions
- What is Mentorup Life Lab & Clinic's NPI number?
- Mentorup Life Lab & Clinic's National Provider Identifier (NPI) is 1063104511, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mentorup Life Lab & Clinic?
- Mentorup Life Lab & Clinic is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Mentorup Life Lab & Clinic located?
- Mentorup Life Lab & Clinic's practice location on file with NPPES is 535 Jack Warner Pkwy Ne Ste G2, Tuscaloosa, AL 35404-5715.
- What is Mentorup Life Lab & Clinic's phone number?
- The practice phone number listed in the NPPES registry for Mentorup Life Lab & Clinic is (205) 771-2261.
- Who is the authorized official for Mentorup Life Lab & Clinic?
- The authorized official listed on Mentorup Life Lab & Clinic's NPPES record is Ellory Johnson, Medical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mentorup Life Lab & Clinic's NPI active?
- Yes — Mentorup Life Lab & Clinic's NPI (1063104511) is active in the NPPES registry as of the last update on 2023-05-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.