SUTTER LAKESIDE HOSPITAL (NPI# 1053495879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053495879 |
| Entity Type | Organization |
| Organization Name | SUTTER LAKESIDE HOSPITAL |
| Other Organization Name | UPPER LAKE CLINIC RHC |
| Practice Address |
5176 Hill Rd E Lakeport CA 95453-6300 |
| Practice Telephone | 7072625001 |
| Practice Fax Number | 7072625006 |
| Mailing Telephone | 7072625001 |
| Mailing Fax Number | 7072625006 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KELLY MATHER (CEO) |
| Authorized Official Telephone | 7072625001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Upper Lake Clinic RHC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073745337 | Sutter Lakeside Hospital | Clinic/Center | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2009-08-19 |
| 1407962459 | Sutter Lakeside Hospital | Clinic/Center | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2006-08-22 |
| 1629089875 | Sutter Lakeside Hospital | Medicare Defined Swing Bed Unit | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2006-08-11 |
| 1063407229 | Sutter Lakeside Hospital | General Acute Care Hospital | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2005-09-14 |
| Street Address |
5176 HILL RD E |
| City | LAKEPORT |
| State | CA |
| Zip Code | 95453-6300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023013125 | Myron P. Schneider | Radiology | 5176 Hill Rd E, Dept of Imaging, Lakeport, CA 95453-6300 | 2005-06-15 |
| 1417441080 | Farallon Inpatient Medical Group Inc | Emergency Medicine | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2018-06-18 |
| 1093171522 | California Advanced Imaging Medical Associates, Inc. | Radiology | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2016-01-13 |
| 1831597517 | Sutter West Bay Hospitals | Clinic/Center | 5176 Hill Rd E, Modular Building, Lakeport, CA 95453-6300 | 2014-12-12 |
| 1710300504 | California Pacific Pathology Medical Group | Pathology | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2014-01-29 |
| 1194068635 | Lake County Anesthesia PC | Anesthesiology | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2013-04-03 |
| 1841541455 | Richelle M Gaiter | Physician Assistant | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2012-09-21 |
| 1023380334 | Kimberley Curtis | Acupuncturist | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2012-02-01 |
| 1770816829 | Sutter Bay Hospitals | Clinic/Center | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2009-09-08 |
| 1598098642 | Sutter Bay Hospitals | Medicare Defined Swing Bed Unit | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2009-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427526847 | Easter Seals Bay Area | Early Intervention Provider Agency | 1950 Parallel Drive, Lakeport, CA 95453 | 2018-11-03 |
| 1285000810 | Lake County Tribal Health Consortium, Inc. | Clinic/Center | 14678 Lakeshore Boulevard, Clearlake, CA 95453 | 2015-08-18 |
| 1942558721 | Lorena A Watson | Nurse Practitioner | 5108 Hill Road East, Lakeport, CA 95453 | 2012-08-27 |
| 1992024657 | Jennifer Stolworthy Smith | Case Manager/Care Coordinator | 991 Parallel Dr. Ste. B, County of Lake, Mental Health, Lakeport, CA 95453 | 2010-05-20 |
| 1376720664 | June Arisa Masato | Marriage & Family Therapist | 1152 S. Main St, Lakeport, CA 95453 | 2008-01-29 |
| 1245417021 | Robert Ryan Taylor Sr. | Physical Therapist | 1285 S Main Street, Lakeport, CA 95453 | 2008-01-24 |
| 1760669618 | Joan Kammerer | Registered Nurse | 922 Bevins Court, Lakeport, CA 95453 | 2008-01-23 |
| 1881878353 | Mary Theresa Mcmillan | Marriage & Family Therapist | 75 Fourth Street, Lakeport, CA 95453 | 2007-12-19 |
| 1922288984 | Robert William Krause | Family Medicine | 755 Eleventh St, Lakeport, CA 95453 | 2007-11-07 |
| 1568683092 | Dan Sleeth | Marriage & Family Therapist | 991 Parallel Dr., Lakeport, CA 95453 | 2007-05-01 |
| Find all providers in zip 95453 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417027095 | Adventist Health Clearlake Hospital Inc | Clinic/Center | 487 S Main St, Lakeport, CA 95453-5315 | 2006-11-09 |
| 1871063040 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 801 11th St, Lakeport, CA 95453-4100 | 2018-11-30 |
| 1831597517 | Sutter West Bay Hospitals | Clinic/Center | 5176 Hill Rd E, Modular Building, Lakeport, CA 95453-6300 | 2014-12-12 |
| 1770816829 | Sutter Bay Hospitals | Clinic/Center | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2009-09-08 |
| 1700119856 | Sutter West Bay Hospitals | Clinic/Center | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2009-09-08 |
| 1073745337 | Sutter Lakeside Hospital | Clinic/Center | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2009-08-19 |
| 1407962459 | Sutter Lakeside Hospital | Clinic/Center | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699620 | Reedley Community Hospital | Clinic/Center | 398 S Church Road, Earlimart, CA 93219 | 2020-11-06 |
| 1174130942 | Kaweah Delta Health Care District | Clinic/Center | 1000 N Mooney Blvd, Tulare, CA 93274-2417 | 2020-09-25 |
| 1922614197 | Sierra View Local Health Care District | Clinic/Center | 9520 Road 238, Terra Bella, CA 93270 | 2020-09-22 |
| 1124643598 | Valley Healthcare Centers | Clinic/Center | 369 N Church Rd, Earlimart, CA 93219 | 2020-06-11 |
| 1477177210 | Anand Narayan Md Inc | Clinic/Center | 317 W El Monte Way, Dinuba, CA 93618-1557 | 2020-06-06 |
| 1902435894 | Slt Medical Group Inc | Clinic/Center | 2024 Lake Tahoe Blvd, South Lake Tahoe, CA 96150-6498 | 2020-04-03 |
| 1881232676 | Madera Community Hospital | Clinic/Center | 121 Belmont Ave., Suite 101, Mendota, CA 93640 | 2019-12-12 |
| 1790331817 | Valley Healthcare Centers | Clinic/Center | 252 N Highway 65, Lindsay, CA 93247-2702 | 2019-08-14 |
| 1093274508 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 6300 E. Highway 20, Lucerne, CA 95458 | 2019-03-14 |
| 1679038434 | Ridgecrest Regional Hospital | Clinic/Center | 105 E Sydnor Ave, Ridgecrest, CA 93555-5546 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SUTTER LAKESIDE HOSPITAL.
| 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.