LAKE SHORE HMA, LLC (NPI# 1386743045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386743045 |
| Entity Type | Organization |
| Organization Name | LAKE SHORE HMA, LLC |
| Other Organization Name | SHANDS LAKE SHORE REGIONAL MEDICAL CENTER |
| Practice Address |
368 Ne Franklin St Lake City FL 32055-3088 |
| Practice Telephone | 3867548000 |
| Practice Fax Number | 3527330069 |
| Mailing Telephone | 3867548000 |
| Mailing Fax Number | 3527330069 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-03-09 |
| Authorized Official Name | PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Telephone | 6159254565 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 4258 | FL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 010033100 | 05 |
| Other Name | Type Code |
|---|---|
| Shands Lake Shore Regional Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912410804 | Lake Shore Hma, LLC | Medicare Defined Swing Bed Unit | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2017-11-14 |
| Street Address |
368 NE FRANKLIN ST |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-3088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457396434 | Paul Richard Schriever | Emergency Medicine | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2006-06-17 |
| 1912410804 | Lake Shore Hma, LLC | Medicare Defined Swing Bed Unit | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2017-11-14 |
| 1295270007 | Columbia Emergency Group LLC | Physician Assistant | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2017-01-03 |
| 1023428539 | Bobbie Lee Rodgers | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2014-05-06 |
| 1821417502 | Stephen Helvey | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2014-04-10 |
| 1770902512 | Gregory A Dyle | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2014-04-09 |
| 1962758342 | Shands Lake Shore Regional Medical Center | General Acute Care Hospital | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2012-08-03 |
| 1346500949 | Foremost Anesthesia Staffing LLC | Anesthesiology | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2012-05-17 |
| 1821317579 | Sergio Bustos Munoz | Pediatrics | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2010-05-20 |
| 1447572037 | Crystal Anne Ferwerda | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2010-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
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|---|---|---|---|---|
| 1568630515 | Department of Veterans Affairs | General Acute Care Hospital | 469 Sw Quail Heights Ter, Lake City, FL 32025-1446 | 2008-02-12 |
| 1295719789 | Lower Florence County Hospital | General Acute Care Hospital | 258 N Ron Mcnair Blvd, Lake City, SC 29560-2462 | 2005-11-30 |
| 1639783889 | Caroline Collins | General Acute Care Hospital | 340 Nw Commerce Dr, Lake City, FL 32055-4709 | 2020-09-04 |
| 1831545680 | Veterans Affairs | General Acute Care Hospital | 619 S Marion Ave, Lake City, FL 32025-5808 | 2016-05-11 |
| 1962522326 | Mid-carolina Hospital Group, LLC | General Acute Care Hospital | 258 N Ron Mcnair Blvd, Lake City, SC 29560-2462 | 2007-03-30 |
| 1841398807 | Departmentf Veterans Affairs | General Acute Care Hospital | 619 S Marion Ave, Lake City, FL 32025-5808 | 2006-09-20 |
| 1992751879 | Notami Hospitals of Florida Inc | General Acute Care Hospital | 340 Nw Commerce Dr, Lake City, FL 32055-4709 | 2006-05-25 |
| 1508815630 | Gainesville Vamc | General Acute Care Hospital | 619 S Marion Ave, Lake City, FL 32025-5808 | 2006-05-08 |
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| 1003465097 | Medical Center of Deltona, Inc. | General Acute Care Hospital | 3300 Halifax Crossings Blvd., Deltona, FL 32725 | 2019-09-11 |
| 1437652500 | Physicians On Call I Corp | General Acute Care Hospital | 10081 Pines Blvd Ste B, Pembroke Pines, FL 33024-6171 | 2018-03-14 |
| 1396272589 | Sacred Heart Hospital | General Acute Care Hospital | 2552 Carmel Heights Rd, Pensacola, FL 32504 | 2017-05-18 |
| 1659803435 | Palmetto General Hosptial | General Acute Care Hospital | 2001 West 68th St, Suite 202, Hialeah, FL 33016 | 2017-03-30 |
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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.