LAKESIDE YOUTH N KIDS PEDIATRICS (NPI# 1275903833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275903833 |
| Entity Type | Organization |
| Organization Name | LAKESIDE YOUTH N KIDS PEDIATRICS |
| Practice Address |
6055 W 46th Ave Wheat Ridge CO 80033-1811 |
| Practice Telephone | 9163007534 |
| Mailing Telephone | 9163007534 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | DR. LANCE JESSE LAZATIN (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 9163007534 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
50291 | CO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 63008564 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Lakeside Youth N Kids Pediatrics PLLC | 6055 W 46th Ave., Ste A, Wheat Ridge, CO 80033 |
| Street Address |
6055 W 46TH AVE |
| City | WHEAT RIDGE |
| State | CO |
| Zip Code | 80033-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437146636 | Ronald Leroy Sweet | Dentist | 6055 W 46th Ave, Wheat Ridge, CO 80033-1811 | 2005-10-03 |
| 1215127311 | Lance J Lazatin | Pediatrics | 6055 W 46th Ave, Suite A, Wheat Ridge, CO 80033-1811 | 2007-07-26 |
| 1437216033 | Sandra Jeanne Symes-gilbert | Nurse Practitioner | 6055 W 46th Ave, Wheat Ridge, CO 80033 | 2007-01-02 |
| 1700988995 | Ronald Daniel Mahoney | Dentist | 6055 W 46th Ave, #a, Wheat Ridge, CO 80033-1811 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154893915 | Bronwyn Hockersmith | Counselor | 3954 Yosemite St, Wheat Ridge, CO 80033 | 2018-12-18 |
| 1902392004 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 4891 Independence St Ste 285, Wheat Ridge, CO 80033 | 2018-07-02 |
| 1528586120 | Front Range Family Resource Center | Marriage & Family Therapist | 5181 Ward St Ste 201, Wheat Ridge, CO 80033 | 2017-09-03 |
| 1962920918 | Dianna Lee Cordero | Counselor | 4931 Garrison St., Apt 104, Wheat Ridge, CO 80033 | 2017-08-30 |
| 1396261525 | Lauren Faye Petasne | Nurse Practitioner | 7100 W 44th Ave Ste 101a, Wheat Ridge, CO 80033 | 2017-08-18 |
| 1558802421 | Elizabeth Ann Huddleston | Nurse Practitioner | 3400 N Lutheran Pkwy, Wheat Ridge, CO 80033 | 2017-03-13 |
| 1053777045 | Richard Kerry Brandow | Counselor | 16625 W 50th Ave., Golden, CO 80033 | 2016-01-07 |
| 1831562131 | Eternal Life Care Centers, LLC | Assisted Living Facility | 4370 Ingalls Street, Wheat Ridge, CO 80033 | 2015-11-09 |
| 1740663483 | Real Care, Inc. | Private Vehicle | 10200 West 44th Ave, Suite 200, Wheat Ridge, CO 80033 | 2015-06-30 |
| 1508254848 | Pamela June Weitzel | Midwife | 3555 Lutheran Parkway Suite 210, Wheat Ridge, CO 80033 | 2015-01-08 |
| Find all providers in zip 80033 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902262751 | Walnut Ridge Family Medicine | Clinic/Center | 7110 W 44th Ave, Wheat Ridge, CO 80033-4724 | 2016-01-09 |
| 1275559569 | Pediatrics West, P.C. | Clinic/Center | 3555 Lutheran Parkway, Suite 200, Wheat Ridge, CO 80033-6027 | 2006-07-14 |
| 1013491208 | Inner City Health Center | Clinic/Center | 6301 W 38th Ave, Wheat Ridge, CO 80033-5057 | 2018-09-24 |
| 1013070051 | Wheat Ridge Family Clinic PC | Clinic/Center | 6301 W 38th Ave, Wheat Ridge, CO 80033-5057 | 2006-12-19 |
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| 1386261493 | Keystone Primary Care | Clinic/Center | 11111 E Mississippi Ave Ste 112, Aurora, CO 80012-3106 | 2020-07-06 |
| 1518582865 | Pediatrics West, P.C. | Clinic/Center | 13402 W Coal Mine Ave Ste 200, Littleton, CO 80127-5407 | 2020-06-12 |
| 1902420862 | Cloud Medical LLC | Clinic/Center | 3601 Arapahoe Ave # D-176, Boulder, CO 80303-1310 | 2020-06-05 |
| 1063034221 | Premier Primary Care Clinic LLC | Clinic/Center | 3000 Lawrence St, Denver, CO 80205-3422 | 2020-05-11 |
| 1992330500 | Quality Medical Clinic LLC | Clinic/Center | 3604 Galley Rd Ste 201, Colorado Springs, CO 80909-4301 | 2020-03-04 |
| 1992344659 | Metropolitan General Practice PC | Clinic/Center | 7400 E Crestline Cir Ste 105, Greenwood Village, CO 80111-3656 | 2019-12-29 |
| Find all providers with the same taxonomy | ||||
| City | WHEAT RIDGE |
| Zip Code | 80033 |
Please comment or provide details below to improve the information on LAKESIDE YOUTH N KIDS PEDIATRICS.
| 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.