BACK TO LIFE MEDICAL GROUP, LLC
BACK TO LIFE MEDICAL GROUP, LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1396987152, based in Canton, GA. It is classified under Family Medicine Physician.
Getting there
The practice address on file is 557 RIVERSTONE PKWY SUITE 140, Canton, GA 30114. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 048997 | GA | Family Medicine Physician primary |
This provider holds licence 048997 issued in GA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 1658422456
Enrolled in Medicare 2 times, across 1 state:
| State | Enrollment ID | Provider type |
|---|---|---|
| Georgia | O20090707000351 | Part B Supplier - Clinic/group Practice |
| Georgia | O20110503000274 | Dme Supplier - Physician - General Practice |
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. There are 2 separate enrolment records. Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Family Medicine covers
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. NUCC Health Care Provider Taxonomy, code 207Q00000X
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1396987152 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Mar 25, 2009 |
| Last updated | Nov 10, 2014 |
| Status | Active |
| Practice address |
557 RIVERSTONE PKWY SUITE 140 Canton, GA 30114 (770) 345-2000 Fax (770) 345-4524 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 3 | 9 | 6 | 9 | 8 | 7 | 1 | 5 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 3 | 9 | 6 | 9 | 8 | 5 | 1 | 1 |
Sum = 68 · next multiple of 10 = 70 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.