LAKE REGIONAL HEALTH SYSTEM (NPI# 1700177128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700177128 |
| Entity Type | Organization |
| Organization Name | LAKE REGIONAL HEALTH SYSTEM |
| Other Organization Name | LAKE REGIONAL CLINIC - LAKE OZARK |
| Practice Address |
1870 Bagnell Dam Blvd Lake Ozark MO 65049-8658 |
| Mailing Address |
Po Box 1500 Osage Beach MO 65065-1500 |
| Practice Telephone | 5733652318 |
| Practice Fax Number | 5733653009 |
| Mailing Telephone | 5733488074 |
| Mailing Fax Number | 5733488069 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2015-08-10 |
| Authorized Official Name | 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 | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1700177128 | 05 |
| Other Name | Type Code |
|---|---|
| Lake Regional Clinic - Lake Ozark | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346530797 | Lake Regional Health System | Clinic/Center | 14298 W Us Highway 54, Macks Creek, MO 65786-6730 | 2011-04-19 |
| 1427162254 | Lake Regional Health System | Clinic/Center | 156 Missouri Boulevard, Suite B, Laurie, MO 65038-4933 | 2006-08-18 |
| 1740255520 | Lake Regional Health System | Home Health | 1193 Highway Kk, Ste C, Osage Beach, MO 65065-3344 | 2006-02-23 |
| 1548743412 | Lake Regional Health System | Clinic/Center | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2018-09-07 |
| 1417492091 | Lake Regional Health System | Hospice Care, Community Based | 1193 Highway Kk, Osage Beach, MO 65065-3344 | 2017-01-05 |
| 1962828616 | Lake Regional Health System | Family Medicine | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2014-03-05 |
| 1295151959 | Lake Regional Health System | General Acute Care Hospital | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2014-03-05 |
| 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 |
| 1437440856 | Lake Regional Health System | Clinic/Center | 1930 N Business Route 5, Unit 1a, Camdenton, MO 65020-2659 | 2011-04-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LAKE REGIONAL HEALTH SYSTEM | 54 Hospital Dr, Osage Beach, MO 65065-3050 |
| Street Address |
1870 BAGNELL DAM BLVD |
| City | LAKE OZARK |
| State | MO |
| Zip Code | 65049-8658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003812918 | Karen S. Hayes | Nurse Practitioner | 1870 Bagnell Dam Blvd, Lake Ozark, MO 65049-8658 | 2005-06-24 |
| 1962853986 | Kimber Guinn | Pediatrics | 1870 Bagnell Dam Blvd, Lake Ozark, MO 65049-8658 | 2016-06-30 |
| 1760848410 | Jennifer Covie Vargas | Nurse Practitioner | 1870 Bagnell Dam Blvd, Lake Ozark, MO 65049-8658 | 2016-01-11 |
| 1205067477 | Dennis L Albers | Pharmacist | 1870 Bagnell Dam Blvd, Lake Ozark, MO 65049-8658 | 2009-08-05 |
| 1043460322 | Colleen Annette Cueni-smith | Physical Therapist | 1870 Bagnell Dam Blvd, Lake Ozark, MO 65049-8658 | 2008-09-24 |
| 1255364311 | Teresa E Loney | Psychologist | 1870 Bagnell Dam Blvd, Suite B, Lake Ozark, MO 65049-8658 | 2006-07-09 |
| 1477595684 | Jeffrey L Piontek | Family Medicine | 1870 Bagnell Dam Blvd, Lake Ozark, MO 65049-8658 | 2006-06-12 |
| 1396783445 | Virginia A Nagy | Family Medicine | 1870 Bagnell Dam Blvd, Lake Ozark, MO 65049-8658 | 2006-06-02 |
| 1164472973 | Laura Rogers | Specialist/Technologist | 1870 Bagnell Dam Blvd, Suite B, Lake Ozark, MO 65049-8658 | 2006-05-11 |
| 1760445134 | Juanita J Jones | Nurse Practitioner | 1870 Bagnell Dam Blvd, Lake Ozark, MO 65049-8658 | 2006-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679099725 | Embark By Calo | Counselor | 110 Crossing Drive Suite 1, Lake Ozark, MO 65049 | 2017-08-21 |
| 1184006843 | Whitney Lodge | Pharmacist | 1870-c Bagnell Blvd, Lake Ozark, MO 65049 | 2015-06-18 |
| 1083907869 | Darin Thomas Puppel | Massage Therapist | 121 Crossings W, Ste F, Lake Ozark, MO 65049 | 2011-05-26 |
| 1407011851 | The Lime In The Coconut Specialty Compounding Pharmacy, LLC | Pharmacy | 121 Crossings West, # F, Lake Ozark, MO 65049 | 2008-07-25 |
| 1821270620 | Barnes Medical Clinic PC | Clinic/Center | 121 Crossings West Drive, #5, Lake Ozark, MO 65049 | 2007-12-04 |
| 1316130784 | Change Academy At Lake of The Ozarks | Psychiatric Residential Treatment Facility | 130 Calo Lane, Lake Ozark, MO 65049 | 2007-08-20 |
| 1891825592 | Karen L. Jenkins | Speech-Language Pathologist | 1571 Bagnell Dam Blvd., Box 1960, Lake Ozark, MO 65049 | 2007-03-06 |
| 1689741035 | Morrow Chiropractic Clinic PC | Chiropractor | 3225 Bagnell Dam Boulevard, Lake Ozark, MO 65049 | 2006-11-29 |
| 1891802443 | Lake Regional Medical Management, Inc | Durable Medical Equipment & Medical Supplies | 1870-c Bagnell Dam Blvd, Lake Ozark, MO 65049 | 2006-08-23 |
| 1033659545 | Marshal Morrow | Chiropractor | 3225 Bagnell Dam Boulevard, Lake Ozark, MO 65049 | 2017-03-02 |
| Find all providers in zip 65049 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| Find all providers with the same taxonomy | ||||
| City | LAKE OZARK |
| Zip Code | 65049 |
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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.