LAKE HOSPITAL SYSTEM INC (NPI# 1932143856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932143856 |
| Entity Type | Organization |
| Organization Name | LAKE HOSPITAL SYSTEM INC |
| Other Organization Name | PRIMEHEALTH PEDIATRICS MADISON |
| Practice Address |
6270 N Ridge Rd Madison OH 44057-2567 |
| Mailing Address |
Po Box 714328 Columbus OH 43271-4328 |
| Practice Telephone | 4404286225 |
| Practice Fax Number | 4404288226 |
| Mailing Telephone | 8003541985 |
| Mailing Fax Number | 4403504938 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-09-06 |
| Authorized Official Name | MR. ROBERT TRACZ (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4403541051 |
| Is Organization Subpart | Y |
| Parent Organization Name | LAKE HOSPITAL SYSTEM, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2017230 | 05 |
| Other Name | Type Code |
|---|---|
| PrimeHealth Pediatrics Madison | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518264043 | Lake Hospital System Inc | Clinic/Center | 2 Success Blvd, Perry, OH 44081-9404 | 2011-02-18 |
| 1164697629 | Lake Hospital System Inc | Internal Medicine | 2747 Som Center Rd, Willoughby, OH 44094-9164 | 2008-04-25 |
| 1952339996 | Lake Hospital System Inc | Surgery | 16030 E High St Ste 101, Middlefield, OH 44062-9474 | 2006-06-29 |
| 1366484818 | Lake Hospital System Inc | Family Medicine | 6990 Lindsay Dr, #3, Mentor, OH 44060-4981 | 2006-06-11 |
| 1538101985 | Lake Hospital System Inc | Family Medicine | 510 Fifth Avenue, Chardon, OH 44024 | 2006-06-11 |
| 1912375601 | Lake Hospital System Inc | Pharmacy | 36000 Euclid Ave, Willoughby, OH 44094-4625 | 2015-09-11 |
| 1922390012 | Lake Hospital System Inc | Clinic/Center | 6067 N Ridge Rd, Madison, OH 44057-2441 | 2011-05-06 |
| 1851698435 | Lake Hospital System Inc | Nurse Practitioner | 7590 Auburn Rd, Concord Twp, OH 44077-9176 | 2011-02-17 |
| 1972689172 | Lake Hospital System Inc | Psychiatric Unit | 36000 Euclid Ave, Willoughby, OH 44094-4662 | 2006-10-31 |
| 1013951920 | Lake Hospital System Inc | Pediatrics | 9485 Mentor Ave, 101, Mentor, OH 44060 | 2006-06-15 |
| Street Address |
6270 N RIDGE RD |
| City | MADISON |
| State | OH |
| Zip Code | 44057-2567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134189376 | Lake Hospital System, Inc | Internal Medicine | 6270 N Ridge Rd, Madison, OH 44057-2567 | 2006-03-23 |
| 1790026680 | Sarah Elizabeth Gerhardstein | General Practice | 6270 N Ridge Rd, Madison, OH 44057-2567 | 2013-03-03 |
| 1275736241 | Toni Gianfagna | Physical Therapy Assistant | 6270 N Ridge Rd, Madison, OH 44057-2567 | 2007-06-07 |
| 1508829607 | Cynthia Lynne Rogers | Physical Therapist | 6270 N Ridge Rd, Madison, OH 44057-2567 | 2006-04-10 |
| 1689634727 | Fathallah Hayek | Emergency Medicine | 6270 N Ridge Rd, Madison, OH 44057-2567 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376028332 | Charlotte F Kister | Assisted Living Facility | 2358 Hubbard Road, Madison, OH 44057 | 2018-09-26 |
| 1861862336 | Living Opportunities, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6873 Dave Drive, Madison, OH 44057 | 2015-09-28 |
| 1548526650 | Jessica Cook | Family Medicine | 6270 North Ridge Rd, Madison, OH 44057 | 2012-04-03 |
| 1164651428 | Dr. Edward S. Friedman, Optometrist Inc. | Optometrist | 6067 North Ridge Rd., Madison, OH 44057 | 2009-07-08 |
| 1023259546 | Northern Dental Specialists, Dr. Steven W Gajda | Dentist | 2040 Hubbard Road, Madison, OH 44057 | 2009-03-12 |
| 1295908267 | Nathan Tekavec | Physical Therapist | 2583 Walter Green Commons, Madison, OH 44057 | 2008-04-10 |
| 1124228556 | Alan B Spiegel | Pediatrics | 6270 N. Ridge Road, Lake Health Physician Group Madison Pediatrics, Madison, OH 44057 | 2007-07-24 |
| 1083828149 | Mary Kathleen Tascone | Registered Nurse | 6205 Campbell Dr, Madison, OH 44057 | 2007-05-09 |
| 1801016043 | Donna Marie Jones | Home Health Aide | 6082 N Ridge Rd, Madison, OH 44057 | 2007-04-30 |
| 1356466445 | Kist Family Chiropractic & Wellness Centre Inc. | Chiropractor | 2711 Hubbard Rd, Madison, OH 44057 | 2007-03-20 |
| Find all providers in zip 44057 | ||||
| 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 |
|---|---|---|---|---|
| 1255947297 | Gluckstadt Tc Kids, LLC | Pediatrics | 101 Lexington Dr Ste A, Madison, MS 39110-6986 | 2020-09-16 |
| 1417488180 | Erin Olsen Pierce | Pediatrics | 8490 Highway 72 W Ste 100, Madison, AL 35758-9575 | 2017-03-24 |
| 1396193454 | Helen Gerseny Waterman | Pediatrics | 123 E Mifflin St Apt 200, Madison, WI 53703-2810 | 2016-05-31 |
| 1093193690 | Ashley Przybilla | Pediatrics | Group Health Cooperative of South Central Wisconsin, 675 West Washington Avenue, Madison, WI 53703 | 2015-05-14 |
| 1780070086 | Christina Amend | Pediatrics | American Family Childrens Hospital 600 Highland Ave, Madison, WI 53792 | 2015-04-13 |
| 1093109316 | Justin M. Lay | Pediatrics | 7726 Old Canton Road, Madison, MS 39110 | 2015-03-25 |
| 1740617414 | Claudette Onyelobi Adegboro | Pediatrics | 1010 Mound St, Room 414, Madison, WI 53715-1532 | 2013-09-26 |
| 1659660330 | Christina Hanowsky Bryndzia | Pediatrics | Uw Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792-0001 | 2011-04-01 |
| 1225357122 | Andrea R Carberry | Pediatrics | American Family Childrens, 600 Highland Ave, H4/4 Mc: 4108, Madison, WI 53792-0001 | 2010-05-18 |
| 1649413550 | Maud Hillevi Regne-karlsson | Pediatrics | 3503 Gregory St, Madison, WI 53711-1727 | 2009-04-08 |
| Find all providers in MADISON | ||||
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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.