Lifesource of North Carolina
NPI 1962940817 · General Practice Physician · Rome, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lifesource of North Carolina is a General Practice Physician organization in Rome, GA (NPI 1962940817).
Provider details
- NPI number
- 1962940817
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Lifesource of North Carolina
- Organization subpart
- Yes
- Authorized official
- Peggy Baddour, President(910) 777-9165
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Psychologist103T00000X
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
Other names (DBA / former)
- Doing business as
- Lifesource of Georgia
- Doing business as
- Lifesource of Georgia
Registry dates
- Enumerated
- 2017-02-10
- Last updated
- 2021-03-26
- Certified
- 2021-03-26
Frequently asked questions
- What is Lifesource of North Carolina's NPI number?
- Lifesource of North Carolina's National Provider Identifier (NPI) is 1962940817, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lifesource of North Carolina?
- Lifesource of North Carolina is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Lifesource of North Carolina located?
- Lifesource of North Carolina's practice location on file with NPPES is 1345 Redmond Cir Nw, Rome, GA 30165-1307.
- What is Lifesource of North Carolina's phone number?
- The practice phone number listed in the NPPES registry for Lifesource of North Carolina is (910) 742-9243.
- Does Lifesource of North Carolina accept Medicare?
- Lifesource of North Carolina is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lifesource of North Carolina?
- The authorized official listed on Lifesource of North Carolina's NPPES record is Peggy Baddour, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lifesource of North Carolina's NPI active?
- Yes — Lifesource of North Carolina's NPI (1962940817) is active in the NPPES registry as of the last update on 2021-03-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.