LAKE HOSPITAL SYSTEM, INC. (NPI# 1912181595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912181595 |
| Entity Type | Organization |
| Organization Name | LAKE HOSPITAL SYSTEM, INC. |
| Other Organization Name | PRIMEHEALTH PEDIATRICS CHARDON |
| Practice Address |
510 Fifth Avenue Chardon OH 44024 |
| Mailing Address |
P.o. Box 714328 Columbus OH 43271-4328 |
| Practice Telephone | 4402791526 |
| Practice Fax Number | 4402791527 |
| Mailing Telephone | 4403541899 |
| Mailing Fax Number | 4403541089 |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |
| Authorized Official Name | ROBERT B. TRACZ (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4403541642 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PrimeHealth Pediatrics Chardon | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265765317 | Lake Hospital System, Inc. | Internal Medicine | 1223 Mentor Ave, Painesville, OH 44077-1833 | 2009-09-08 |
| 1366721763 | Lake Hospital System, Inc. | Family Medicine | 26151 Euclid Ave, Suite 201, Euclid, OH 44132-3322 | 2011-08-16 |
| 1184910747 | Lake Hospital System, Inc. | General Acute Care Hospital | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2011-06-22 |
| 1477844686 | Lake Hospital System, Inc. | Surgery | 9500 Mentor Ave, Suite 300, Mentor, OH 44060-8713 | 2011-04-21 |
| 1669783593 | Lake Hospital System, Inc. | Family Medicine | 7956 Tyler Blvd, Mentor, OH 44060-4806 | 2010-06-25 |
| 1578884797 | Lake Hospital System, Inc. | Orthopaedic Surgery | 7580 Auburn Rd, Suite 214, Painesville, OH 44077-9615 | 2010-06-22 |
| 1174844724 | Lake Hospital System, Inc. | Surgery | 9500 Mentor Ave, Suite 200, Mentor, OH 44060-8713 | 2010-06-17 |
| 1710207329 | Lake Hospital System, Inc. | Obstetrics & Gynecology | 9485 Mentor Ave, Suite 202, Mentor, OH 44060-4597 | 2010-06-04 |
| 1669609756 | Lake Hospital System, Inc. | Surgery | 20050 Harvard Ave, Warrensville Heights, OH 44122-6816 | 2009-06-16 |
| 1124255278 | Lake Hospital System, Inc. | Surgery | 36001 Euclid Ave, B-3, Willoughby, OH 44094-4643 | 2009-06-16 |
| Street Address |
510 FIFTH AVENUE |
| City | CHARDON |
| State | OH |
| Zip Code | 44024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538101985 | Lake Hospital System Inc | Family Medicine | 510 Fifth Avenue, Chardon, OH 44024 | 2006-06-11 |
| 1023225448 | Melanie J Malec | Family Medicine | 510 Fifth Avenue, Chardon, OH 44024 | 2007-05-16 |
| 1497861744 | Carol L Noall | Family Medicine | 510 Fifth Avenue, Chardon, OH 44024 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992336770 | Amanda Nicole Nelson | Technician, Other | 133 Up Main St, Chardon, OH 44024 | 2020-01-30 |
| 1679067011 | Janai Marshae Seng | Dentist | 401 South Street #3a, Chardon, OH 44024 | 2018-06-19 |
| 1376036475 | Kasandra Leigh Chapman | Social Worker | 12941 Ravenna Road, Chardon, OH 44024 | 2018-06-13 |
| 1275068652 | Danielle Tilton | Nurse Practitioner | 531 Fifth Ave, Chardon, OH 44024 | 2017-04-24 |
| 1881057040 | Erin Marie Moore | Counselor | 203 Main St., Chardon, OH 44024 | 2016-04-04 |
| 1649689886 | Hope Anne Super | Speech-Language Pathologist | 100 7th Av Suite 255, Chardon, OH 44024 | 2014-08-12 |
| 1740600022 | Elisha Tzvi Fredman | Student in an Organized Health Care Education/Training Program | 13207 Chardon Road, Ravenna, OH 44024 | 2014-04-24 |
| 1083039309 | Jamie Delvecchio | Family Medicine | 150 7th Ave Ste 200, Chardon, OH 44024 | 2014-02-24 |
| 1174947212 | Frank Scarano | Psychologist | 470 Center Street, Chardon, OH 44024 | 2014-02-10 |
| 1659706497 | Jamie Henderson | Physical Therapy Assistant | 9348 South Brown Rd, Chardon, OH 44024 | 2013-09-12 |
| Find all providers in zip 44024 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982805917 | University Primary Care Practices Inc | Pediatrics | 150 7th Ave Ste 110, Chardon, OH 44024-2909 | 2007-05-29 |
| 1518065580 | Laura S Mason | Pediatrics | 13241 Ravenna Rd Ste A, Chardon, OH 44024-9012 | 2006-09-21 |
| 1326142803 | Eva L Bhadra | Pediatrics | 13241 Ravenna Road, Chardon, OH 44024 | 2006-09-12 |
| 1649746124 | Bo Elizabeth Espinosa-setchko | Pediatrics | 13241 Ravenna Rd, Chardon, OH 44024-9012 | 2018-10-22 |
| 1417046251 | Ann Louise Failinger | Pediatrics | 13241 Ravenna Road, Chardon, OH 44024 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184237968 | Greater Cleveland Pediatrics | Pediatrics | 3311 Richmond Rd, Beachwood, OH 44122-4195 | 2020-08-31 |
| 1528677085 | Mariam Khan | Pediatrics | 2277 Summit St, Columbus, OH 43202-3131 | 2020-07-30 |
| 1447879200 | Amy C Buck | Pediatrics | 30 Kim Ct W, Westerville, OH 43081-2554 | 2020-04-13 |
| 1376170381 | Kathleen Sibyl Kress Farrell | Pediatrics | 14701 Detroit Ave Ste 250, Lakewood, OH 44107-4109 | 2020-03-27 |
| 1710526702 | Rebecca K Cibik | Pediatrics | 2497 State Route 59, Kent, OH 44240 | 2019-12-23 |
| 1992354344 | Rouba Sayegh | Pediatrics | 315 Frankfort Sq, Columbus, OH 43206-1061 | 2019-09-09 |
| 1972164556 | Grace Nikolai | Pediatrics | 9000 N Main St Ste 332, Englewood, OH 45415-1185 | 2019-06-25 |
| 1376012393 | Ohio North East Health Systems, Inc | Pediatrics | 2642 State Route 5, Cortland, OH 44410-9393 | 2018-11-20 |
| 1477022606 | Anthony George Pucell | Pediatrics | 1120 Gordon Rd, Lyndhurst, OH 44124-1335 | 2018-11-16 |
| 1861988875 | Sandeep Randhawa | Pediatrics | Rupert Health Centre, Utmc Campus, 3125, Transverse Drive, Toledo, OH 43614 | 2018-07-03 |
| 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.