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Lifesource Prime Inc

Family Medicine Physician in Clinton, SC · enumerated 2024 · authorized official Peggy Baddour, President/Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1851143523

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Registry record

Entity type Organization (Type 2)
Legal business name Lifesource Prime Inc
Practice address 939 Springdale Dr, Clinton, SC, 29325
Phone (910) 742-9243
Fax (888) 746-1787
Enumeration date Apr 4, 2024
Last updated in NPPES Oct 28, 2025

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary
208D00000X General Practice Physician Allopathic & Osteopathic Physicians Secondary
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Secondary
363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary
363LF0000X Family Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary
363LG0600X Gerontology Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary
363LP2300X Primary Care Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Peggy Baddour
Title President/Owner
Phone (910) 742-9243

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Lifesource Prime Inc?
Lifesource Prime Inc is registered in NPPES as a Family Medicine Physician (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-10-28.