OrganizationActive
Lifeline Vascular Center Niceville LLC
NPI 1962849794 · Vascular & Interventional Radiology Physician · Niceville, FL
Provider details
- NPI number
- 1962849794
- Entity type
- Organization
- Primary specialty
- Vascular & Interventional Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jason Lohmeyer, Cfo(847) 949-3855
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Nephrology Physician207RN0300X
Allopathic & Osteopathic Physicians
- Vascular Surgery Physician2086S0129X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 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
4585 E Highway 20 Ste 125
Niceville, FL 32578-7709
Phone: (850) 678-0184
Fax: (850) 678-0155
Street-level locationGet directions
Mailing address
Po Box 782282
Philadelphia, PA 19178-2282
Registry dates
- Enumerated
- 2013-06-03
- Last updated
- 2021-06-30
- Certified
- 2021-06-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.