Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lifesource Prime Inc

Organization Family Medicine Physician · NPI 1598533275

Lifesource Prime Inc provides Family Medicine Physician services in Wilmington, North Carolina. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone: (910) 742-9243
Fax: (888) 746-1787
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1598533275
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Peggy Baddour — Ceo · (910) 742-9243
NPI enumeratedDecember 13, 2023
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025
Mailing addressPo Box 740343, Atlanta, GA 30374-0343

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