LAKE GIRL, INC (NPI# 1255730446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255730446 |
| Entity Type | Organization |
| Organization Name | LAKE GIRL, INC |
| Other Organization Name | HOMETOWN FAMILY MEDICINE |
| Practice Address |
4581 Gravois Rd House Springs MO 63051-1374 |
| Practice Telephone | 6366719980 |
| Practice Fax Number | 6366719981 |
| Mailing Telephone | 6366719980 |
| Mailing Fax Number | 6366719981 |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2017-09-26 |
| Authorized Official Name | MRS. RENEE L WILLER (OWNER) |
| Authorized Official Telephone | 3143227017 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
138512 | MO | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Hometown Family Medicine | Doing Business As Name - Organization |
| Street Address |
4581 GRAVOIS RD |
| City | HOUSE SPRINGS |
| State | MO |
| Zip Code | 63051-1374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477530814 | Renee L Willer | Nurse Practitioner | 4581 Gravois Rd, House Springs, MO 63051-1374 | 2005-12-28 |
| 1649640657 | Heather D Krafve | Nurse Practitioner | 4581 Gravois Rd, House Springs, MO 63051-1374 | 2015-10-02 |
| 1568614477 | Almiron Clinic, Inc. | Family Medicine | 4581 Gravois Rd, House Springs, MO 63051 | 2008-10-22 |
| 1992727093 | Osias A Almiron | Family Medicine | 4581 Gravois Rd, House Springs, MO 63051 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821440579 | Caregiver's Choice LLC | Nursing Care | 12 Gravis Station Road, House Springs, MO 63051 | 2016-07-06 |
| 1851730881 | Amber Nichole Farmar | Behavioral Analyst | 4270 Nw Point Dr., House Springs, MO 63051 | 2013-06-24 |
| 1497038947 | Rebecca Rea O'reilly | Pharmacist | 4535 Hunter Ln, House Springs, MO 63051 | 2011-09-21 |
| 1154495893 | Janice Herr Rowley | Massage Therapist | 6607 North Dr, Byrnes Mill, MO 63051-1031 | 2006-11-17 |
| 1922004928 | Leon Romaine | Optometrist | 4575 Gravois Rd, House Springs, MO 63051-1374 | 2005-06-23 |
| 1386697910 | Clarkson Eyecare | Optometrist | 4575 Gravois Rd, House Springs, MO 63051-1374 | 2006-05-17 |
| 1891712659 | Lin Kris Pharmacy Inc | Pharmacy | 4642 House Springs Ctr, House Springs, MO 63051-1376 | 2006-07-17 |
| 1962664573 | Lin-kris Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 4642 House Springs Ctr, House Springs, MO 63051-1376 | 2008-06-26 |
| 1700878303 | Melanie G Hampton | Pediatrics | 100 Osage Executive Cir, House Springs, MO 63051-1382 | 2005-08-19 |
| 1497220594 | Amanda Faye Whistler | Nurse Practitioner | 100 Osage Executive Cir, Byrnes Mill, MO 63051-1382 | 2018-10-04 |
| Find all providers in zip 63051 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1174145668 | Essential Benefit Offerings, LLC | Clinic/Center | 1417 N Mount Auburn Rd Ste A2, Cape Girardeau, MO 63701-2171 | 2020-05-07 |
| 1114483468 | Your Optimal Healthcare LLC | Clinic/Center | 300 W 4th St Ste H, Eureka, MO 63025-1839 | 2019-02-12 |
| 1306313051 | Country Care Family Clinic, LLC | Clinic/Center | 3 E Cleveland Ave, Ellsinore, MO 63937 | 2018-10-31 |
| 1285118950 | Vera Whole Health, Wa PC | Clinic/Center | 8350 N. Church Road, Kansas City, MO 64158 | 2018-09-19 |
| 1003324542 | Quad/med, LLC | Clinic/Center | 2015 Ne Jefferson Street, Grain Valley, MO 64029 | 2018-01-18 |
| 1093267601 | Careatc-saint Peter | Clinic/Center | 4601 Executive Centre Pkwy, Saint Peters, MO 63376-1683 | 2016-10-30 |
| 1407303480 | Kerns Family Health Care LLC | Clinic/Center | 1335 Vilage Dr B, St. Joseph, MO 64506-2457 | 2016-09-07 |
| 1316491020 | Wecare Tlc - Wwt Mo Family Health Center | Clinic/Center | 58 Weldon Pkwy, Bldg 58, Maryland Heights, MO 63043-3237 | 2016-08-10 |
| 1255703500 | Community Hospital Association | Clinic/Center | 101 South Washington Street, Oregon, MO 64473 | 2015-10-27 |
| 1023485752 | Dennis E. Robinson D.o. | Clinic/Center | 487 Pomme De Terre Dr., Marshfield, MO 65706 | 2015-08-28 |
| Find all providers with the same taxonomy | ||||
| City | HOUSE SPRINGS |
| Zip Code | 63051 |
Please comment or provide details below to improve the information on LAKE GIRL, INC.
| 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.