LAKE REGIONAL MEDICAL MANAGEMENT, INC. (NPI# 1598882656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598882656 |
| Entity Type | Organization |
| Organization Name | LAKE REGIONAL MEDICAL MANAGEMENT, INC. |
| Other Organization Name | LAKE REGIONAL ORTHOPEDICS |
| Practice Address |
1075 Nichols Rd Suite 3-4 Osage Beach MO 65065-3093 |
| Mailing Address |
Po Box 1500 Osage Beach MO 65065-1500 |
| Practice Telephone | 5733023990 |
| Practice Fax Number | 5733022753 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2019-07-02 |
| Authorized Official Name | MR. DAVID W. HALSELL (SR. V.P., CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5733488388 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1639134158 | 05 |
| Other Name | Type Code |
|---|---|
| Lake Regional Orthopedics | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 441 W Elm St, Lebanon, MO 655363523 | 4175322805 | 4175322848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780116657 | Lake Regional Medical Management, Inc. | Pharmacy | 416b S Maple St, Eldon, MO 65026-1812 | 2017-03-30 |
| 1407960479 | Lake Regional Medical Management, Inc. | Pharmacy | 1930-c North Business Route 5, Camdenton, MO 65020-2659 | 2006-08-18 |
| 1154701803 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 54 Hospital Dr, Suite 213, Osage Beach, MO 65065-3050 | 2015-06-08 |
| 1609273259 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 7-8, Osage Beach, MO 65065-3093 | 2014-11-25 |
| 1386926939 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 1-2, Osage Beach, MO 65065-3093 | 2011-09-09 |
| 1174814545 | Lake Regional Medical Management, Inc. | Clinic/Center | 5816 Hwy 54, Suite 111, Osage Beach, MO 65065-3046 | 2011-04-20 |
| 1639134158 | Lake Regional Medical Management, Inc. | Clinic/Center | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2006-04-18 |
| Street Address |
1075 NICHOLS RD SUITE 3-4 |
| City | OSAGE BEACH |
| State | MO |
| Zip Code | 65065-3093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518966571 | Miriam B. Borden | Internal Medicine | 1075 Nichols Rd, Osage Beach, MO 65065-3093 | 2005-07-20 |
| 1083249213 | Hailey Dunn | Nurse Practitioner | 1075 Nichols Rd, Osage Beach, MO 65065-3093 | 2020-03-09 |
| 1942682984 | Stacy Lynn Young | Nurse Practitioner | 1075 Nichols Rd, Osage Beach, MO 65065-3093 | 2015-06-26 |
| 1609273259 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 7-8, Osage Beach, MO 65065-3093 | 2014-11-25 |
| 1386926939 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 1-2, Osage Beach, MO 65065-3093 | 2011-09-09 |
| 1407150998 | Springfield Neurological and Spine Institute | Neurological Surgery | 1075 Nichols Rd, Ste. #5 & #6, Osage Beach, MO 65065-3093 | 2010-12-27 |
| 1588975973 | Ryan Charles Morris | Orthopaedic Surgery | 1075 Nichols Rd, Osage Beach, MO 65065 | 2010-06-30 |
| 1366768939 | Cody Lee Fox | Podiatrist | 1075 Nichols Rd, Suite 1-2, Osage Beach, MO 65065-3093 | 2010-04-08 |
| 1265629620 | Valerie Dalphine Donnelson | Physician Assistant | 1075 Nichols Rd, Osage Beach, MO 65065-3093 | 2007-10-01 |
| 1164643201 | Eric R Varboncouer | Orthopaedic Surgery | 1075 Nichols Rd, Osage Beach, MO 65065-3093 | 2007-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778859 | Suzanne Marie Harris | Social Worker | 1191 State Highway Kk, Suite 101, Osage Beach, MO 65065 | 2020-04-15 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1245723337 | William T Mcfail | Counselor | 1191 State Hwy Kk, Suite 101, Osage Beach, MO 65065 | 2018-06-13 |
| 1588102263 | Jennifer Kiske | Physical Therapist | 5780 Osage Beach Parkway, Ste 220, Osage Beach, MO 65065 | 2017-02-02 |
| 1700207586 | Brenda Renee Spies | Pharmacist | 4252 Osage Beach Parkway, Osage Beach, MO 65065 | 2013-12-23 |
| 1154668465 | Paige Hedgpath Od, PC | Optometrist | 4645g Osage Beach Parkway, Osage Beach, MO 65065 | 2013-01-07 |
| 1649548330 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 300 Kestrel Lane, Lake Ozark, MO 65065 | 2011-12-08 |
| 1437399821 | Melissa Nicole Morgan | Physical Therapy Assistant | 5177 Vicus Castri, Osage Beach, MO 65065 | 2009-02-25 |
| 1730330911 | Raymond Don Baker | Preventive Medicine | 5476 Stone Ledge Cir, Osage Beach, MO 65065 | 2008-10-06 |
| 1457514259 | Lake Family Dentistry | Dentist | 1037 Palisades Blvd Ste 9, Osage Beach, MO 65065 | 2008-07-02 |
| Find all providers in zip 65065 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598304917 | Elite Pain Management, LLC | Durable Medical Equipment & Medical Supplies | 5780 Osage Beach Pkwy Ste 113, Osage Beach, MO 65065-3188 | 2020-01-02 |
| 1548275589 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3938 Osage Beach Pkwy, Osage Beach, MO 65065-2146 | 2006-07-29 |
| 1871510115 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 4252 Osage Beach Pkwy, Osage Beach, MO 65065-2171 | 2006-07-16 |
| 1750311411 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 1063 Armory Dr, Osage Beach, MO 65065 | 2006-07-05 |
| 1043248115 | Hy Vee Inc | Durable Medical Equipment & Medical Supplies | 929 Highway D, Osage Beach, MO 65065-3169 | 2006-06-29 |
| 1598706921 | Hy Vee Inc | Durable Medical Equipment & Medical Supplies | 5816 Osage Beach Pkwy, Suite 104, Osage Beach, MO 65065-3046 | 2006-06-09 |
| 1154701803 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 54 Hospital Dr, Suite 213, Osage Beach, MO 65065-3050 | 2015-06-08 |
| 1609273259 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 7-8, Osage Beach, MO 65065-3093 | 2014-11-25 |
| 1679997407 | Lake Regional Health System | Durable Medical Equipment & Medical Supplies | 54 Hospital Dr, Suite 201, Osage Beach, MO 65065-3050 | 2014-02-14 |
| 1376883843 | Lake Regional Health System | Durable Medical Equipment & Medical Supplies | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2013-02-21 |
| Find all providers in OSAGE BEACH | ||||
| City | OSAGE BEACH |
| Zip Code | 65065 |
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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.