Provider Demographics
NPI:1639836950
Name:INSPIRE MEDICAL GROUP PC
Entity Type:Organization
Organization Name:INSPIRE MEDICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LERLA
Authorized Official - Middle Name:GEORGETTE
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-386-7855
Mailing Address - Street 1:1500 W ELK AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-2655
Mailing Address - Country:US
Mailing Address - Phone:423-677-5524
Mailing Address - Fax:
Practice Address - Street 1:921 HULL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-4069
Practice Address - Country:US
Practice Address - Phone:949-694-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30017500750001Medicaid