SUZANNE C GULLOTTA (NPI# 1699872010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699872010 |
| Entity Type | Organization |
| Organization Name | SUZANNE C GULLOTTA |
| Other Organization Name | LAKESIDE FAMILY HEALTH CENTER |
| Practice Address |
77 Deer Creek Road Somers MT 59932 |
| Mailing Address |
Po Box 649 Lakeside MT 59922-0649 |
| Practice Telephone | 4068572997 |
| Mailing Telephone | 4068572997 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-01-18 |
| Authorized Official Name | MRS. SUZANNE C GULLOTTA (OWNER) |
| Authorized Official Telephone | 4068572997 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
020838 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0434707 | 05 | |
| MT | BCBS | 037108 | 01 |
| Other Name | Type Code |
|---|---|
| Lakeside Family Health Center | Doing Business As Name - Organization |
| Street Address |
77 DEER CREEK ROAD |
| City | SOMERS |
| State | MT |
| Zip Code | 59932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487124913 | Ariane Nicole Waller | Social Worker | 1543 Mackinaw Loop, Somers, MT 59932 | 2018-11-27 |
| 1306276035 | Lakeside Wellness PC | Clinic/Center | 77 Deer Cr Rd, Suite B, Somers, MT 59932 | 2013-11-15 |
| 1962401372 | Suzanne C Gullotta | Nurse Practitioner | 77 Deer Creek Rd, Somers, MT 59932 | 2005-07-18 |
| 1528288149 | County of Flathead School District 29 | Local Education Agency (LEA) | 315 School Edition Road, Somers, MT 59932-0159 | 2007-04-26 |
| 1699872986 | Denise Lynn Davies | Specialist | 113 Pavillion Hill Rd, Somers, MT 59932-0186 | 2006-09-20 |
| 1053665091 | Lakeside Clinic P.C. | Clinic/Center | 77 Deer Creek Rd, Somers, MT 59932-8000 | 2012-10-30 |
| 1790223162 | Nicole Lea Roberts | Counselor | 401 S Eighty Dr, Somers, MT 59932-8501 | 2017-02-06 |
| 1730261777 | Myia L Powers | Counselor | 375 N Juniper Bay Rd, Somers, MT 59932-9739 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265052724 | Paul A Barakat | Physical Therapist | 2811, 189 Ny-100, Somers, NY 10589 | 2020-04-24 |
| 1962040402 | John Steven Caswell | Hearing Instrument Specialist | 11 Maple Ridge Dr, Somers, CT 06071-1501 | 2019-12-16 |
| 1255978243 | Lucia Francesca Moore | Physical Therapist | 325 Route 100 # 106, Somers, NY 10589-3227 | 2019-12-09 |
| 1295372456 | Vincent Orlando Jr. | Physical Therapist | 325 Route 100 Ste 106, Somers, NY 10589-3227 | 2019-12-06 |
| 1528616505 | Jessica Leah Ware | Counselor | 73a Main St, Somers, CT 06071-1836 | 2019-09-03 |
| 1629626478 | Jacqueline Cavuoto | Early Intervention Provider Agency | 96 Mitchell Rd, Somers, NY 10589-1801 | 2019-08-26 |
| 1770046682 | Zahira Cortez | Licensed Practical Nurse | 5 Lee Rd, Somers, NY 10589-2603 | 2019-04-08 |
| 1487112819 | Carolyn Constance Greenfield | Midwife | 76 Billings Rd, Somers, CT 06071-1924 | 2019-03-05 |
| 1285191437 | Kathryn Michelle Pojer | Counselor | 380 Heritage Hls Unit D, Somers, NY 10589-4099 | 2019-02-25 |
| 1710441043 | Maureen G Karoglanian | Psychologist | 38 Stonehouse Rd, Somers, NY 10589-2510 | 2019-01-31 |
| Find all providers in SOMERS | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255878773 | Jennifer Briggs | Nurse Practitioner | 146 Main Street, Somers, CT 06071-1825 | 2017-01-22 |
| 1609092824 | Carol Theodore | Nurse Practitioner | Colonial Court, 374 Route 116, Somers, NY 10589 | 2007-04-17 |
| 1962401372 | Suzanne C Gullotta | Nurse Practitioner | 77 Deer Creek Rd, Somers, MT 59932 | 2005-07-18 |
| 1760957526 | Suzanne Marie Viger | Nurse Practitioner | 146 Main St, Somers, CT 06071-1214 | 2018-10-09 |
| 1205378353 | Somers Family Practice | Nurse Practitioner | 24 Battle St, Suite 1a, Somers, CT 06071-1629 | 2016-11-07 |
| 1083032882 | Merin Sanoj Joseph | Nurse Practitioner | 189 Route 100, Somers, NY 10589-2811 | 2014-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114872 | Harold James Horine IIi | Nurse Practitioner | 43 Meadow Lark Ln, Deer Lodge, MT 59722-9540 | 2020-11-06 |
| 1073110268 | Heidi Kearns | Nurse Practitioner | 1038 3rd Ave E, Kalispell, MT 59901-5642 | 2020-10-01 |
| 1730796699 | Brandy Colvin | Nurse Practitioner | 709 N Aster Ave, Bozeman, MT 59718-6991 | 2020-09-25 |
| 1518571686 | Megan Gittings Fnp-c Pllc | Nurse Practitioner | 55 W 14th St Ste 102, Helena, MT 59601-3387 | 2020-09-04 |
| 1528672979 | Melanie Funke | Nurse Practitioner | 272 Aswan Pl, Billings, MT 59105-2910 | 2020-09-02 |
| 1831716927 | Chloe Marie Georgeton | Nurse Practitioner | 1288 N 14th Ave Ste 201, Bozeman, MT 59715-8535 | 2020-07-06 |
| 1629697784 | Stephani Conner | Nurse Practitioner | 604 Pine Pl, Whitefish, MT 59937-2362 | 2020-04-09 |
| 1518590645 | William Todd Wohlman | Nurse Practitioner | 3458 Baldwin Rd, Stevensville, MT 59870-2904 | 2020-02-17 |
| 1578104253 | Nora Caitlin Healy | Nurse Practitioner | 201 North 10th Street, Hamilton, MT 59840 | 2019-10-03 |
| 1730737115 | Julie Ann Emerson | Nurse Practitioner | 3244 S 26th Ave, Bozeman, MT 59718-7434 | 2019-08-29 |
| Find all providers with the same taxonomy | ||||
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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.