LAKE REGIONAL MEDICAL MANAGEMENT, INC. (NPI# 1174814545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174814545 |
| Entity Type | Organization |
| Organization Name | LAKE REGIONAL MEDICAL MANAGEMENT, INC. |
| Other Organization Name | LAKE REGIONAL URGENT CARE |
| Practice Address |
5816 Hwy 54 Suite 111 Osage Beach MO 65065-3046 |
| Mailing Address |
Po Box 1500 Osage Beach MO 65065-1500 |
| Practice Telephone | 5733023200 |
| Practice Fax Number | 5733023210 |
| Mailing Telephone | 5733488074 |
| Mailing Fax Number | 5733488069 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2011-04-29 |
| Authorized Official Name | KRISTEN L PRENGER (MANAGED CARE DIRECTOR) |
| Authorized Official Telephone | 5733488162 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lake Regional Urgent Care | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780116657 | Lake Regional Medical Management, Inc. | Pharmacy | 416b S Maple St, Eldon, MO 65026-1812 | 2017-03-30 |
| 1407960479 | Lake Regional Medical Management, Inc. | Pharmacy | 1930-c North Business Route 5, Camdenton, MO 65020-2659 | 2006-08-18 |
| 1154701803 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 54 Hospital Dr, Suite 213, Osage Beach, MO 65065-3050 | 2015-06-08 |
| 1609273259 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 7-8, Osage Beach, MO 65065-3093 | 2014-11-25 |
| 1386926939 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 1-2, Osage Beach, MO 65065-3093 | 2011-09-09 |
| 1598882656 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 3-4, Osage Beach, MO 65065-3093 | 2007-03-23 |
| 1639134158 | Lake Regional Medical Management, Inc. | Clinic/Center | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2006-04-18 |
| Street Address |
5816 HWY 54 SUITE 111 |
| City | OSAGE BEACH |
| State | MO |
| Zip Code | 65065-3046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487729612 | James E Eisenhardt | Chiropractor | 5816 Hwy 54, Ste 110, Osage Beach, MO 65065-3046 | 2006-11-22 |
| 1952689101 | James E Eisenhardt Dc PC | Chiropractor | 5816 Hwy 54, Ste 110, Osage Beach, MO 65065 | 2011-07-21 |
| 1023178571 | Jerry D Harl | Dentist | 5816 Hwy 54, Suite 107, Osage Beach, MO 65065 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778859 | Suzanne Marie Harris | Social Worker | 1191 State Highway Kk, Suite 101, Osage Beach, MO 65065 | 2020-04-15 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1245723337 | William T Mcfail | Counselor | 1191 State Hwy Kk, Suite 101, Osage Beach, MO 65065 | 2018-06-13 |
| 1588102263 | Jennifer Kiske | Physical Therapist | 5780 Osage Beach Parkway, Ste 220, Osage Beach, MO 65065 | 2017-02-02 |
| 1700207586 | Brenda Renee Spies | Pharmacist | 4252 Osage Beach Parkway, Osage Beach, MO 65065 | 2013-12-23 |
| 1154668465 | Paige Hedgpath Od, PC | Optometrist | 4645g Osage Beach Parkway, Osage Beach, MO 65065 | 2013-01-07 |
| 1649548330 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 300 Kestrel Lane, Lake Ozark, MO 65065 | 2011-12-08 |
| 1437399821 | Melissa Nicole Morgan | Physical Therapy Assistant | 5177 Vicus Castri, Osage Beach, MO 65065 | 2009-02-25 |
| 1730330911 | Raymond Don Baker | Preventive Medicine | 5476 Stone Ledge Cir, Osage Beach, MO 65065 | 2008-10-06 |
| 1457514259 | Lake Family Dentistry | Dentist | 1037 Palisades Blvd Ste 9, Osage Beach, MO 65065 | 2008-07-02 |
| Find all providers in zip 65065 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245520691 | Lake Regional Health System | Clinic/Center | 1057 Medical Park Dr, Suite A, Osage Beach, MO 65065-3000 | 2011-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102137 | Washington County Memorial Hospital | Clinic/Center | 14206 Hwy C, Belgrade, MO 63622 | 2020-07-23 |
| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| Find all providers with the same taxonomy | ||||
| City | OSAGE BEACH |
| Zip Code | 65065 |
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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.