LAKE HEALTH DISTRICT (NPI# 1376698522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376698522 |
| Entity Type | Organization |
| Organization Name | LAKE HEALTH DISTRICT |
| Other Organization Name | LAKE DISTRICT HOSPITAL |
| Practice Address |
700 S J St Lakeview OR 97630-1623 |
| Practice Telephone | 5419472114 |
| Practice Fax Number | 5419472433 |
| Mailing Telephone | 5419472114 |
| Mailing Fax Number | 5419472433 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2019-01-17 |
| Authorized Official Name | MR. GORDON ENSLEY (CEO) |
| Authorized Official Telephone | 5419472114 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC0050X |
Clinic/Center Specialization: Critical Access Hospital |
140896 | OR | Ambulatory Health Care Facilities |
| N | 314000000X | Skilled Nursing Facility | 1836773096 | OR | Nursing & Custodial Care Facilities |
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
140896 | OR | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 106146 | 05 | |
| OR | MEDICAID OREGON HEALTH | 107532 | 01 |
| OR | MEDICAIDORE.HEALTHL.T.C. | 802595 | 01 |
| Other Name | Type Code |
|---|---|
| Lake District Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669945713 | Lake Health District | Clinic/Center | 100 N D St Ste 100, Lakeview, OR 97630-1552 | 2019-01-10 |
| 1699183236 | Lake Health District | Clinic/Center | 700 South J St, Lakeview, OR 97630 | 2014-07-28 |
| 1326187261 | Lake Health District | Clinic/Center | 670 County Rd 83, Canby, CA 96015 | 2007-02-06 |
| 1851399695 | Lake Health District | Medicare Defined Swing Bed Unit | 700 S J St, Lakeview, OR 97630-1623 | 2005-07-13 |
| 1285062489 | Lake Health District | Clinic/Center | 535 S Main St, Alturas, CA 96101-4114 | 2013-10-24 |
| 1285789438 | Lake Health District | Long Term Care Hospital | 700 S J St, Lakeview, OR 97630-1623 | 2007-01-25 |
| 1518012764 | Lake Health District | Hospice Care, Community Based | 700 S J St, Lakeview, OR 97630-1623 | 2007-01-25 |
| 1992850143 | Lake Health District | Home Health | 700 S J St, Lakeview, OR 97630-1623 | 2007-01-25 |
| 1588719876 | Lake Health District | Pharmacy | 700 S J St, Lakeview, OR 97630-1623 | 2007-01-24 |
| Street Address |
700 S J ST |
| City | LAKEVIEW |
| State | OR |
| Zip Code | 97630-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851399695 | Lake Health District | Medicare Defined Swing Bed Unit | 700 S J St, Lakeview, OR 97630-1623 | 2005-07-13 |
| 1942815071 | Amron L Lym | Physical Therapist | 700 S J St, Lakeview, OR 97630-1623 | 2020-09-15 |
| 1538774062 | Jedediah James Adams | Physical Therapist | 700 S J St, Lakeview, OR 97630-1623 | 2020-09-11 |
| 1649889148 | Mesa Greenfield | Registered Nurse | 700 S J St, Lakeview, OR 97630-1623 | 2020-07-30 |
| 1821615584 | Joseph D Hermann | Social Worker | 700 S J St, Lakeview, OR 97630-1623 | 2020-06-29 |
| 1063075406 | Julia Snedigar | Speech-Language Pathologist | 700 S J St, Lakeview, OR 97630-1623 | 2019-04-22 |
| 1003238668 | Ellen Edith Mouser | Nurse Practitioner | 700 S J St, Lakeview, OR 97630-1623 | 2014-01-15 |
| 1821428442 | Erin Danielle Steward | Physician Assistant | 700 S J St, Lakeview, OR 97630-1623 | 2013-11-18 |
| 1871840868 | Rosanne Fitzgerald | Nurse Practitioner | 700 S J St, Lake Health Clinic, Lakeview, OR 97630-1623 | 2012-08-08 |
| 1932479201 | Lake District Hospital Physicians Group | General Acute Care Hospital | 700 S J St, Lakeview, OR 97630-1623 | 2012-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891186326 | Susan Ann Mungarro | Counselor | 215 North G Street, Lakeview, OR 97630 | 2015-02-05 |
| 1699183236 | Lake Health District | Clinic/Center | 700 South J St, Lakeview, OR 97630 | 2014-07-28 |
| 1912059569 | Howards Pharmacy Inc | Pharmacy | 101 North F St, Lakeview, OR 97630 | 2007-01-16 |
| 1316056120 | Michael Sabin Dmd PC | Dentist | 733 N 1st Street, Lakeview, OR 97630 | 2006-08-29 |
| 1174586564 | Donald Frank Ott | Nurse Anesthetist, Certified Registered | 700 S J, Lakeview, OR 97630 | 2006-04-08 |
| 1760922033 | Darrel Kyniston Kyniston | Counselor | 215 North G Street, Lakeview, OR 97630 | 2017-03-06 |
| 1518376722 | Lakeview Gardens LLC | Skilled Nursing Facility | 700 South J St, Lakeview, OR 97630 | 2014-08-13 |
| 1457407264 | Angelyn Ray | Social Worker | 100 N. D Street, Office # 208 The Marius Building, Lakeview, OR 97630-0000 | 2007-01-25 |
| 1003823790 | Mary Juree Anderson | Registered Nurse | 530 Sunset, Lakeview, OR 97630-0032 | 2006-08-02 |
| 1225232663 | Barbara Joanne Vandenberg | Counselor | Po Box 948, Lakeview, OR 97630-0037 | 2007-06-11 |
| Find all providers in zip 97630 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1598909426 | Spectrum Heatlh Kelsey | General Acute Care Hospital | 418 Washington St, Lakeview, MI 48850-9806 | 2009-04-22 |
| 1538102173 | Spectrum Health Kelsey | General Acute Care Hospital | 418 Washington St, Lakeview, MI 48850-7102 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609328301 | Northwest Medical Foundation of Tillamook | General Acute Care Hospital | 200 Se Hwy 224, Suite 100, Estacada, OR 97023-7022 | 2016-10-28 |
| 1568808285 | Northwest Medical Foundation of Tillamook | General Acute Care Hospital | 36155 9th St, Room 4, Nehalem, OR 97131-8000 | 2013-05-21 |
| 1154699379 | Northwest Medical Foundation of Tillamook | General Acute Care Hospital | 10445 Neah-kah-nie Cr Rd, Manzanita, OR 97130 | 2011-12-02 |
| 1730223967 | Coquille Valley Hospital District | General Acute Care Hospital | 940 East Fifth Street, Coquille, OR 97423 | 2007-02-19 |
| 1700809761 | Columbia Lutheran Charities | General Acute Care Hospital | 550 22nd St, Astoria, OR 97103-3312 | 2006-07-25 |
| 1588684484 | Southern Coos Health District | General Acute Care Hospital | 900 11th St Se, Bandon, OR 97411-9114 | 2006-07-20 |
| 1376572099 | Morrow County Health District | General Acute Care Hospital | 564 East Pioneer Drive, Heppner, OR 97836 | 2006-07-03 |
| 1306897491 | Samaritan North Lincoln Hospital | General Acute Care Hospital | 3043 Ne 28th Street, Lincoln City, OR 97367-4518 | 2006-05-13 |
| 1689625980 | Mid Valley Healthcare Inc | General Acute Care Hospital | 525 N Santiam Highway, Lebanon, OR 97355-4363 | 2006-05-12 |
| 1871575225 | Northwest Medical Foundation of Tillamook | General Acute Care Hospital | 1000 3rd St, Tillamook, OR 97141-3430 | 2005-11-18 |
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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.