LAKE HOSPITAL SYSTEM (NPI# 1346202512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346202512 |
| Entity Type | Organization |
| Organization Name | LAKE HOSPITAL SYSTEM |
| Practice Address |
36000 Euclid Ave Willoughby OH 44094-4625 |
| Mailing Address |
Po Box 714110 Columbus OH 43271-4110 |
| Practice Telephone | 4403541618 |
| Practice Fax Number | 4403541848 |
| Mailing Telephone | 4402745035 |
| Mailing Fax Number | 4407168608 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2012-08-10 |
| Authorized Official Name | MR. MICHAEL KITTOE (CFO) |
| Authorized Official Telephone | 4403541952 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282N00000X | General Acute Care Hospital | Hospitals | ||
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | UNITED HEALTHCARE | 5000142 | 01 |
| OH | QUALCHOICE | 18300 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942580394 | Lake Hospital System | Family Medicine | 8316 Yellowbrick Rd, Mentor, OH 44060-4960 | 2011-08-17 |
| 1710295829 | Lake Hospital System | Internal Medicine | 36100 Euclid Ave, Suite 400, Willoughby, OH 44094-4456 | 2010-09-23 |
| 1326141987 | Lake Hospital System | Internal Medicine | 29804 Lakeshore Blvd, Willowick, OH 44095 | 2006-09-07 |
| 1255394136 | Lake Hospital System | Dietitian, Registered | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2006-04-11 |
| Street Address |
36000 EUCLID AVE |
| City | WILLOUGHBY |
| State | OH |
| Zip Code | 44094-4625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356340061 | Gary Salovon | Anesthesiology | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2005-07-15 |
| 1568070548 | Nicole Lepore | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2020-07-16 |
| 1881202026 | Marwa Azem | Pharmacist | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2020-07-14 |
| 1053941195 | Dornice Ivanna Friday | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2020-01-16 |
| 1477013373 | Karolin Seifried Ash | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2019-03-25 |
| 1861959546 | Marlarie C Hardee | Nurse Anesthetist, Certified Registered | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2019-02-28 |
| 1578020905 | Orsolya Eads | Nurse Practitioner | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2019-02-21 |
| 1922586379 | Jonathon Eleeot Henry | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094 | 2018-07-29 |
| 1023595139 | Katherine Elvira Mccormick | Social Worker | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2018-07-20 |
| 1922598291 | James V Czernicki | Anesthesiologist Assistant | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2018-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574367 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 36596 Euclid Ave, Willoughby, OH 44094 | 2020-09-25 |
| 1679111322 | Megan King | Nurse Practitioner | 4078 Erie Street, Unit B, Willoughby, OH 44094 | 2019-12-12 |
| 1124661525 | Mind and Body Infusion Therapies, LLC | Clinic/Center | 9264 Chillicothe Rd., Unit #2, Kirtland, OH 44094 | 2019-10-18 |
| 1679125637 | Christina Maria Chandler | Family Medicine | 39021 Signature Circle, Willoughby, OH 44094 | 2019-07-10 |
| 1467920595 | Rachel Curry | Specialist/Technologist | 53400 Euclid Ave., Apt. E-102, Willoughby, OH 44094 | 2018-11-07 |
| 1437649753 | Katie Lauren Greenaway | Registered Nurse | 5103 Robinhood Dr, Willoughby, OH 44094 | 2018-05-11 |
| 1003346131 | Heather Marie Hayes | Licensed Practical Nurse | 38882 Mentor Ave., Willoughby, OH 44094 | 2017-06-12 |
| 1609305028 | Ann Marie Mason | Counselor | 38882 Mentor Avenue, Willoughby, OH 44094 | 2017-06-08 |
| 1285173005 | Mattie Diann Towns-scott | Social Worker | 34950 Chardon Road, Bldg 2, Suite 210, Willoughby Hills, OH 44094 | 2017-02-13 |
| 1447797329 | Therese Benz | General Acute Care Hospital | 96000 Euclid Ave., Willoughby, OH 44094 | 2017-01-30 |
| Find all providers in zip 44094 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053427385 | Joi Robinson Tidmore | Obstetrics & Gynecology | 36001 Euclid Avenue, C7, Willoughby, OH 44094 | 2006-08-21 |
| 1043229503 | Abigail Marie Tucker | Obstetrics & Gynecology | 36001 Euclid Avenue C-7, Lake Health Physician Group Ob/gyn, Willoughby, OH 44094 | 2006-08-05 |
| 1700875465 | Christine M Slotta | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2005-10-17 |
| 1841582095 | Leticia Maria Cox | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2011-05-06 |
| 1104054352 | Thomesha Marie Barton | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2009-06-26 |
| 1457451577 | Kelly V. Buchanan | Obstetrics & Gynecology | 36001 Euclid Ave Ste C7, Willoughby, OH 44094-4650 | 2006-09-25 |
| 1013023332 | Philip C Brzozowski | Obstetrics & Gynecology | 36001 Euclid Ave, C-7, Willoughby, OH 44094 | 2006-08-21 |
| 1841234762 | Lake Hospital System Inc | Obstetrics & Gynecology | 36001 Euclid Ave, Suite C-7, Willoughby, OH 44094-4643 | 2006-06-15 |
| 1518920917 | Wendy J Clinger | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2006-04-08 |
| 1043273352 | Janie M Zart | Obstetrics & Gynecology | 4176 State Route 306, Willoughby, OH 44094-9203 | 2006-04-08 |
| Find all providers in WILLOUGHBY | ||||
| City | WILLOUGHBY |
| Zip Code | 44094 |
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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.