LAKE COUNTY FREE MEDICAL CLINIC (NPI# 1730397282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730397282 |
| Entity Type | Organization |
| Organization Name | LAKE COUNTY FREE MEDICAL CLINIC |
| Other Organization Name | FREE CLINIC OF LAKE COUNTY |
| Practice Address |
54 S State St Suite 302 Painesville OH 44077-3445 |
| Mailing Address |
54 S. State St. Suite 302 Painesville OH 44077 |
| Practice Telephone | 4403528686 |
| Practice Fax Number | 4403528107 |
| Mailing Telephone | 4403528686 |
| Mailing Fax Number | 4403528107 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-12-11 |
| Authorized Official Name | MS. ANNATONIA K FETZER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4403528686 |
| Authorized Official Credential | MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251V00000X | Voluntary or Charitable | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0716416 | 05 |
| Other Name | Type Code |
|---|---|
| Free Clinic of Lake County | Former Legal Business Name - Organization |
| Street Address |
54 S STATE ST SUITE 302 |
| City | PAINESVILLE |
| State | OH |
| Zip Code | 44077-3445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982693248 | Margie M Delong | Nurse Practitioner | 54 S State St, Family Planning Association of Northeast Ohio Suite 203, Painesville, OH 44077-3445 | 2005-10-19 |
| 1033478045 | Leslie S Kushner | Advanced Practice Midwife | 54 S State St, Suite 203, Painesville, OH 44077-3445 | 2012-05-10 |
| 1306096524 | Mark Anthony Restifo | Registered Nurse | 54 S State St, Suite 204, Painesville, OH 44077-3445 | 2008-09-24 |
| 1114176310 | Lucille Ann Bertino | Registered Nurse | 54 S State St, Rm 204, Painesville, OH 44077-3445 | 2008-09-11 |
| 1699813410 | Robert S. Forbes Jr. | Chiropractor | 54 S State St, Ste. 301, Painesville, OH 44077-3445 | 2007-02-02 |
| 1437233996 | Thomas Harold Coss | Social Worker | 54 S State St, Suite 204, Painesville, OH 44077-3445 | 2006-10-24 |
| 1194810333 | Laura M Garlisi | Psychiatry & Neurology | 54 S State St, #204, Painesville, OH 44077-3445 | 2006-10-04 |
| 1629172648 | Lois K Novikoff | Registered Nurse | 54 S State St, Painesville, OH 44077-3445 | 2006-09-11 |
| 1114038999 | Barbara Matilde Rodriguez | Psychiatry & Neurology | 54 S State St, Ste 204, Painesville, OH 44077-3445 | 2006-08-31 |
| 1811911282 | Cynthia Patricia Didonato | Social Worker | 54 S State St, Painesville, OH 44077-3445 | 2006-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695594 | Signature Health Inc. Pharmacy | Pharmacy | 54 South Saint Claire, Painesville, OH 44077 | 2020-10-06 |
| 1164053385 | Elaine Marie Nelson | Technician, Other | Cosmetic Laser Inc, 8353 Mentor Ave. Unit 7, Mentor, OH 44077 | 2020-01-27 |
| 1760039309 | Laura Bradford | Occupational Therapy Assistant | 12428 Concord-hambden Road, Concord, OH 44077 | 2019-08-19 |
| 1508418260 | Collin Dees | Physician Assistant | Tripoint Medical Center, 7590 Auburn Road, Painesville, OH 44077 | 2019-07-12 |
| 1093208662 | Lindsey Elaine Varckette | Physical Therapy Assistant | 60 Wood Street, Painesville, OH 44077 | 2018-06-08 |
| 1083116578 | Brian Mills | Hearing Instrument Specialist | 1920 Mentor Ave, Painesville, OH 44077 | 2018-03-01 |
| 1033610324 | Julia Nicole Chase | Pharmacist | 180 W State Street, Painesville, OH 44077 | 2018-02-22 |
| 1104343631 | Donna Sheahan | Nurse Practitioner | 236 Ardmore Blvd, Painesville, OH 44077 | 2017-08-25 |
| 1417474198 | Jacqueline Owens | Registered Nurse | 7757 Auburn Rd, Ste 6 &7, Concord Twp., OH 44077 | 2017-08-24 |
| 1689197303 | Michelle Claire Pierce | Registered Nurse | 311 W. Walnut Ave., Painesville, OH 44077 | 2017-07-25 |
| Find all providers in zip 44077 | ||||
| Taxonomy Code | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326670076 | Miloh Foundation | Voluntary or Charitable | 6307 Northcliff Ave, Brooklyn, OH 44144-4040 | 2020-02-11 |
| 1841821675 | New Housing Opportunities, Inc. | Voluntary or Charitable | 4055 Executive Park Dr Ste 240, Cincinnati, OH 45241-2019 | 2020-01-30 |
| 1346894672 | Volunteers of America Ohio & Indian | Voluntary or Charitable | 115 W Mcmicken Ave, Cincinnati, OH 45202-4915 | 2019-07-25 |
| 1801367057 | Community Resource Coalition for Independence | Voluntary or Charitable | 2959 Fallehn Dr, Cortland, OH 44410-9170 | 2018-12-16 |
| 1417430455 | The Ld Edge Network | Voluntary or Charitable | 3389 Fulton Rd, Cleveland, OH 44109-1463 | 2018-09-14 |
| 1306353560 | Womens Wellness Foundation | Voluntary or Charitable | 5159 Fowler Ave, Cleveland, OH 44127-1565 | 2018-01-09 |
| 1659886349 | Yep Foundation | Voluntary or Charitable | 1821 Summit Rd Ste 400, Cincinnati, OH 45237-2817 | 2017-12-05 |
| 1821513698 | Superior Treasures | Voluntary or Charitable | 4949 Galaxy Pkwy Ste U, Cleveland, OH 44128-5959 | 2017-08-13 |
| 1013456177 | Guiding Light Mentoring | Voluntary or Charitable | 6562 Cheviot Rd, Apartment 1, Cincinnati, OH 45247-5169 | 2017-02-21 |
| 1821537663 | Mental Health America of Franklin County | Voluntary or Charitable | 2323 W 5th Ave Ste 160, Columbus, OH 43204-4988 | 2017-02-13 |
| Find all providers with the same taxonomy | ||||
| City | PAINESVILLE |
| Zip Code | 44077 |
Please comment or provide details below to improve the information on LAKE COUNTY FREE MEDICAL CLINIC.
| 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.