DR. DAVID LAKE GORMSEN (NPI# 1619014602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619014602 |
| Entity Type | Individual |
| Full Name | DR. DAVID LAKE GORMSEN |
| Credential | D.O. |
| Practice Address |
1320 Mercy Dr Nw Canton OH 44708-2614 |
| Mailing Address |
4189 Songbird Trl Stow OH 44224-2572 |
| Practice Telephone | 3304891074 |
| Practice Fax Number | 3304891487 |
| Mailing Telephone | 3306884160 |
| Mailing Fax Number | 3304891487 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
34002838 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | MEDICAL LICENSE NUMBER | 34002838 | 01 |
| Street Address |
1320 MERCY DR NW |
| City | CANTON |
| State | OH |
| Zip Code | 44708-2614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942206230 | Community Dialysis Units, LLC | Clinic/Center | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2005-06-22 |
| 1295333193 | Danielle Kaya | 1320 Mercy Dr Nw, Canton, OH 44708-2641 | 2020-10-13 | |
| 1831796655 | Melissa Lynn Alex | Dietitian, Registered | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2020-10-05 |
| 1902403181 | Katherine Mary Anderson | Dietitian, Registered | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2020-10-01 |
| 1154938496 | Kristen Nicole Wheeler | Dietitian, Registered | 1320 Mercy Dr Nw, Canton, OH 44708-2641 | 2020-09-30 |
| 1669089801 | Mary Lou Keener | Dietitian, Registered | 1320 Mercy Dr Nw, Canton, OH 44708-2641 | 2020-09-30 |
| 1316553175 | Victoria Watt | Nurse Practitioner | 1320 Mercy Dr Nw, Canton, OH 44708-2641 | 2020-09-17 |
| 1124633474 | Lauren Angus | Nurse Anesthetist, Certified Registered | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2020-09-14 |
| 1316550189 | Ryan Daniel Hickey | Nurse Anesthetist, Certified Registered | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2020-08-31 |
| 1669082772 | Cynthia Marie Colt | Anesthesiologist Assistant | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2020-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669072583 | Xl Developmental Services, Inc. | Home Health | 4403 19th St Nw, Canton, OH 44708 | 2020-10-29 |
| 1942827084 | Emily Glor | Dentist | 1320 Mercy Drive Northwest, Attn: Dental Services, Canton, OH 44708 | 2020-07-05 |
| 1811479009 | Linda Adams | Counselor | 2421 13th Street Nw, Canton, OH 44708 | 2018-09-04 |
| 1104308527 | Toreka Lishay Miller | Social Worker | 2421 13th Nw, Canton, OH 44708 | 2018-09-01 |
| 1679051213 | Edward Arthur Hill | Family Medicine | 6104 Cedar Lane Nw, Canton, OH 44708 | 2018-08-06 |
| 1467939371 | Kristen M Reardon | Registered Nurse | 1330 Mercy Dr Nw Ste 319, Canton, OH 44708 | 2018-07-24 |
| 1538659131 | Jeffrey Scott Mechtenberg | Chiropractor | 3410 Tuscarawas Street W, Canton, OH 44708 | 2018-05-18 |
| 1699284844 | Our Caring Hands Home Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3005 W. Tuscuswas St, Canton, OH 44708 | 2017-09-20 |
| 1528580933 | Elizabeth Ann Bonchek | Licensed Practical Nurse | 4550 Hills and Dales Nw Road, Canton, OH 44708 | 2017-07-07 |
| 1518315837 | Bio-medical Applications of Ohio, Inc. | Clinic/Center | 2835 Tuscarawas St. West, Canton, OH 44708 | 2016-05-26 |
| Find all providers in zip 44708 | ||||
| Taxonomy Code | 207PP0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Pediatric Emergency Medicine |
| Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/ Board certification is provided by the American Board of Emergency Medicine. Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891105714 | Onyinyechi Ukwuoma | Emergency Medicine | Cleveland Clinic, Cleveland, OH 44195-5612 | 2014-04-30 |
| 1013337146 | Ryan James Reichert | Emergency Medicine | 1 Perkins Square, Akron Childrens Hospital, Akron, OH 44302 | 2014-04-16 |
| 1659534147 | Erika Fraundorf | Emergency Medicine | 9500 Euclid Ave, Emergency Services Institute E-19, Cleveland, OH 44195-0001 | 2008-07-06 |
| 1295912681 | Kayleene E Pagan Correa | Emergency Medicine | 11100 Euclid Ave, 2071 Cornell Road, Modular #3, Cleveland, OH 44106-1716 | 2008-01-28 |
| 1124217666 | Erin Rae Mcdowell | Emergency Medicine | 11100 Euclid Ave, Rainbow Babies & Children's Hospital, Cleveland, OH 44106-1716 | 2007-10-22 |
| 1023156577 | Leslie Mcdaniel Dingeldein | Emergency Medicine | 11100 Euclid Ave, Cleveland, OH 44106-1716 | 2007-02-04 |
| 1609926286 | Jonathan Israel Singer | Emergency Medicine | 3525 Southern Blvd, Kettering, OH 45429-1221 | 2007-01-12 |
| 1679636567 | Kristen J Paddon | Emergency Medicine | 3333 Burnet Ave, Mlc 7009, Cincinnati, OH 45229-3026 | 2006-12-19 |
| 1205997848 | John B Badcock | Emergency Medicine | 1 Childrens Plz, Dayton, OH 45404-1898 | 2006-12-13 |
| 1033270616 | Mary J Erickson | Emergency Medicine | 1 Childrens Plz, Dayton, OH 45404-1898 | 2006-12-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. DAVID LAKE GORMSEN.
| 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.