LAKE REGIONAL MEDICAL MANAGEMENT (NPI# 1043723901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043723901 |
| Entity Type | Organization |
| Organization Name | LAKE REGIONAL MEDICAL MANAGEMENT |
| Other Organization Name | LAKE REGIONAL ORTHOPEDICS-CAMDENTON |
| Practice Address |
226 E Us Highway 54 Camdenton MO 65020-6819 |
| Mailing Address |
54 Hospital Dr Osage Beach MO 65065-3050 |
| Practice Telephone | 5733463700 |
| Practice Fax Number | 5733463302 |
| Mailing Telephone | 5733488399 |
| Mailing Fax Number | 5733488309 |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |
| Authorized Official Name | JESSICA HASTY (MANAGED CARE COORDINATOR) |
| Authorized Official Telephone | 5733488399 |
| Authorized Official Credential | BSBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 501945604 | 05 |
| Other Name | Type Code |
|---|---|
| Lake Regional Orthopedics-Camdenton | Doing Business As Name - Organization |
| Street Address |
226 E US HIGHWAY 54 |
| City | CAMDENTON |
| State | MO |
| Zip Code | 65020-6819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023031762 | Brian Douglas Swanson | Physician Assistant | 226 E Us Highway 54, Camdenton, MO 65020-6819 | 2006-07-25 |
| 1922434349 | Jefferson City Medical Group, PC | Orthopaedic Surgery | 226 E Us Highway 54, Camdenton, MO 65020-6819 | 2013-09-17 |
| 1609086834 | Leslie Orthopedics and Sports Medicine Inc | Orthopaedic Surgery | 226 E Us Highway 54, Camdenton, MO 65020-6819 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295383024 | Carinda Elynn Steele | Physical Therapy Assistant | 1930 N Business 5, Camdenton, MO 65020 | 2019-08-26 |
| 1831651660 | Erin Elisabeth Sluyter | Physician Assistant | 1652 North Business Route 5, Camdenton, MO 65020 | 2019-04-01 |
| 1922575125 | Serene Shores, LLC | Counselor | 75 Court Circle Se, Camdenton, MO 65020 | 2018-10-26 |
| 1902396591 | Audrey Dawn Sheppard | Counselor | 89 Mccrory Dr, Camdenton, MO 65020 | 2018-05-18 |
| 1427586072 | Abc Laurie LLC | Chiropractor | 139 E Hwy 54 Suite 1c, Camdenton, MO 65020 | 2017-05-26 |
| 1891229878 | Benton Street Counseling LLC | Counselor | 89 Mccrory Drive, Camdenton, MO 65020 | 2017-04-17 |
| 1033658463 | Erica L Asbell | Social Worker | 172 Dare Blvd., Camdenton, MO 65020 | 2017-02-17 |
| 1376816967 | Linda Susan Sheriff | Speech-Language Pathologist | 158 Minor Street, Camdenton, MO 65020 | 2012-02-14 |
| 1285902031 | Gregory Ryan Boren | Pharmacist | 72 South Business Route 5, Camdenton, MO 65020 | 2011-12-08 |
| 1265757033 | Abcs of Wellness, LLC | Chiropractor | 139 E. Hwy 54, 1c, Camdenton, MO 65020 | 2010-04-05 |
| Find all providers in zip 65020 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033486782 | Infinity Endeavors | Durable Medical Equipment & Medical Supplies | 72 S Business Route 5, Camdenton, MO 65020-8892 | 2011-11-23 |
| 1588836415 | Wilkinson Pharmacy, Inc | Durable Medical Equipment & Medical Supplies | 113 E Us Highway 54 Ste 2, Camdenton, MO 65020-7320 | 2008-04-01 |
| 1083886238 | Auburn Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 113 E Us Highway 54, Camdenton, MO 65020-7320 | 2008-03-27 |
| 1063439487 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 94 Cecil St, Camdenton, MO 65020-7057 | 2006-07-16 |
| 1427099860 | Dillon Companies LLC | Durable Medical Equipment & Medical Supplies | 1159 E Us Highway 54, Camdenton, MO 65020 | 2006-06-09 |
| 1346224110 | James E Parker | Durable Medical Equipment & Medical Supplies | 802 N Business Route 5, Camdenton, MO 65020-2646 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407646 | Troutman Enterprises, LLC | Durable Medical Equipment & Medical Supplies | 5337 S Campbell Ave Ste A2, Springfield, MO 65810-2494 | 2020-11-07 |
| 1033719323 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 7001 Blue Ridge Blvd Ste P, Raytown, MO 64133-5629 | 2020-10-27 |
| 1093312241 | Axes Physical Therapy, LLC | Durable Medical Equipment & Medical Supplies | 7483 Mexico Rd, Saint Peters, MO 63376-1304 | 2020-10-01 |
| 1083228233 | Best Care Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 2200 W Port Plaza Dr Ste 220b, Saint Louis, MO 63146-3211 | 2020-09-04 |
| 1194339515 | Neighborhood Ltc Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 4240 Blue Ridge Blvd Ste 100, Kansas City, MO 64133-1703 | 2020-09-02 |
| 1497368773 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1430 Olive St Ste P, Saint Louis, MO 63103-2360 | 2020-08-26 |
| 1124630546 | Midwest Respiratory Care Inc | Durable Medical Equipment & Medical Supplies | 1840 N Commerce Dr, Nixa, MO 65714-7603 | 2020-08-18 |
| 1497373989 | Taylor Made Walk In Tubs LLC | Durable Medical Equipment & Medical Supplies | 420 Nichols Rd, Kansas City, MO 64112-2005 | 2020-07-10 |
| 1487277687 | Medline Industries, Inc. | Durable Medical Equipment & Medical Supplies | 1401 Universal Ave, Kansas City, MO 64120-2139 | 2020-05-21 |
| 1942822549 | Axes Physical Therapy, LLC | Durable Medical Equipment & Medical Supplies | 213 Village Square Shop Ctr, Hazelwood, MO 63042-1838 | 2020-05-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.