DR. BRAD M LAKE (NPI# 1922205160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922205160 |
| Entity Type | Individual |
| Full Name | DR. BRAD M LAKE |
| Credential | M.D. |
| Practice Address |
15813 Paul Vega Md Dr Hammond LA 70403-1426 |
| Mailing Address |
Po Box 2668 Hammond LA 70404-2668 |
| Practice Telephone | 9852307860 |
| Practice Fax Number | 9852307861 |
| Mailing Telephone | 9852307860 |
| Mailing Fax Number | 9852307861 |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2012-08-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | MD.205375 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
15813 PAUL VEGA MD DR |
| City | HAMMOND |
| State | LA |
| Zip Code | 70403-1426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891765954 | Charles R Ducombs | Internal Medicine | 15813 Paul Vega Md Dr, Suite 300, Hammond, LA 70403-1426 | 2006-01-23 |
| 1700444064 | Jamie Theresa Pierre | Audiologist | 15813 Paul Vega Md Dr, Hammond, LA 70403-1426 | 2019-06-03 |
| 1194288068 | Hospital Service District #1 of Tangipahoa Parish | Pharmacy | 15813 Paul Vega Md Dr, Hammond, LA 70403-1426 | 2019-04-09 |
| 1083143457 | Jeni Abrams Dunnington | Audiologist | 15813 Paul Vega Md Dr, Hammond, LA 70403-1426 | 2017-06-08 |
| 1982145470 | Carla Graves | Nurse Practitioner | 15813 Paul Vega Md Dr, Suite 100, Hammond, LA 70403-1426 | 2017-03-16 |
| 1750745964 | Kaila Smith | Nurse Practitioner | 15813 Paul Vega Md Dr, Ste 401 - Urology Clinic, Hammond, LA 70403-1426 | 2016-04-13 |
| 1326405721 | Shawn Dearie | Nurse Practitioner | 15813 Paul Vega Md Dr, Suite 300, Hammond, LA 70403-1426 | 2016-01-15 |
| 1992186100 | Jodee Bernier | Nurse Practitioner | 15813 Paul Vega Md Dr, Suite 202, Hammond, LA 70403-1426 | 2015-06-12 |
| 1659763118 | Corie M Downing | Nurse Practitioner | 15813 Paul Vega Md Dr, Suite 300a, Hammond, LA 70403-1426 | 2015-02-20 |
| 1104227107 | Hannah J Smitherman | Speech-Language Pathologist | 15813 Paul Vega Md Dr, Suite 301, Hammond, LA 70403-1426 | 2014-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074403 | Elizabeth M Norman | Nurse Practitioner | 19065 Dr John Lambert Drive, Hammond, LA 70403 | 2020-02-06 |
| 1942830757 | Trinity Wellness Counseling LLC. | Social Worker | 43171 Tillman Dr, Hammond, LA 70403 | 2020-01-21 |
| 1407419138 | Cypress Pointe Urgent Care, LLC | Clinic/Center | 19065 Dr. John Lambert Drive, Hammond, LA 70403 | 2019-04-18 |
| 1700341724 | Taylor Kioria Johnson | Specialist/Technologist | 40151 Macedonia Rd, Hammond, LA 70403 | 2019-02-04 |
| 1912478264 | Julean Marie Walters | Behavioral Analyst | 1250 Sw Railroad Ave., Suite 130, Hammond, LA - LOUISIANA 70403 | 2018-12-16 |
| 1659849263 | Andie Street | Speech-Language Pathologist | 1000 Cm Fagan Drive, Unit C, Hammond, LA 70403 | 2018-11-13 |
| 1932684701 | Kurt Edwin Dichiara | Chiropractor | 1330 S Magnolia St, Suite B, Hammond, LA 70403 | 2018-09-27 |
| 1225529175 | Heart To Heart Counseling & Counseling | Social Worker | 30430 Dawson Ln, Hammond, LA 70403 | 2018-05-27 |
| 1477041630 | Epiphany Healthcare of Hammond | Psychiatry & Neurology | 906 Cm Fagan Drive Bldg A Ste 6a, Hammond, LA 70403 | 2018-04-24 |
| 1457850158 | Dynamic Performance Chiropractic of Hammond | Chiropractor | 1330 South Magnolia, Suite B, Hammond, LA 70403 | 2018-02-08 |
| Find all providers in zip 70403 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030005 | Red Envelope Apmc | Urology | 15770 Paul Vega Dr Ste 200, Hammond, LA 70403-1475 | 2020-07-07 |
| 1619232774 | Jay Heintz M.d. A Professional Medical LLC | Urology | 15770 Paul Vega Dr, Suite 200, Hammond, LA 70403-1475 | 2012-07-05 |
| 1871597443 | Bonadelvert C Suarez | Urology | 42421 Pelican Professional Park, Hammond, LA 70403-2405 | 2005-06-10 |
| 1326433756 | Jason Chiang | Urology | 15770 Paul Vega Dr, Hammond, LA 70403-1475 | 2015-04-02 |
| 1528397023 | Robert B. Kidd Md Apmc | Urology | 15770 Paul Vega Md Dr, 200, Hammond, LA 70403-1475 | 2009-12-11 |
| 1356514129 | Urology Clinic of Tangipahoa | Urology | 2101 Robin Ave, Suite 1, Hammond, LA 70403-5772 | 2008-04-11 |
| 1568634863 | Urology Clinic of Tangipahoa | Urology | 2101 Robin Ave, Suite 1, Hammond, LA 70403-5772 | 2008-03-26 |
| 1457529679 | Jens F Graversen Md Apm LLC | Urology | 15770 Paul Vega Md Dr, Ste 200, Hammond, LA 70403-1475 | 2008-02-11 |
| 1588850259 | St Margaret Mercy Healthcare Centers | Urology | 5454 Hohman Ave, 1 Floor C, Hammond, IN 46320-1931 | 2007-09-17 |
| 1467650804 | Stephen M Graham | Urology | 15813 Paul Vega Md Dr, Suite 201-a, Hammond, LA 70403-1426 | 2007-07-06 |
| Find all providers in HAMMOND | ||||
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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.