LAKE HOSPITAL SYSTEM, INC. (NPI# 1124255278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124255278 |
| Entity Type | Organization |
| Organization Name | LAKE HOSPITAL SYSTEM, INC. |
| Other Organization Name | LAKE HEALTH PHYSICIAN GROUP VASCULAR ACCESS SURGERY |
| Practice Address |
36001 Euclid Ave B-3 Willoughby OH 44094-4643 |
| Mailing Address |
Po Box 714328 Columbus OH 43271-4328 |
| Practice Telephone | 4409531898 |
| Practice Fax Number | 4409539296 |
| Mailing Telephone | 4403541899 |
| Mailing Fax Number | 4403541089 |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2011-04-25 |
| Authorized Official Name | RICHARD D CICERO (SR. VP, BUSINESS DEVELOPMENT) |
| Authorized Official Telephone | 4403541739 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Lake Health Physician Group Vascular Access Surgery | 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 |
| 1174762512 | Lake Hospital System, Inc. | Family Medicine | 2 Success Blvd., Perry, OH 44081 | 2009-02-09 |
| Street Address |
36001 EUCLID AVE B-3 |
| City | WILLOUGHBY |
| State | OH |
| Zip Code | 44094-4643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013907989 | Ming Huei Phillip Chiang | Family Medicine | 36001 Euclid Ave, B4, Willoughby, OH 44094-4643 | 2005-10-24 |
| 1992306633 | Alisha Howland | Nurse Practitioner | 36001 Euclid Ave, Willoughby, OH 44094-4643 | 2020-11-07 |
| 1699140202 | Phillip W Wallace Dds Inc | Dentist | 36001 Euclid Ave, Suite A-15, Willoughby, OH 44094-4643 | 2015-12-08 |
| 1366787624 | Anthony James Lorenzo | Acupuncturist | 36001 Euclid Ave, Suite A-6, Willoughby, OH 44094-4643 | 2012-11-27 |
| 1447542790 | Austin Charles Homrighaus | Acupuncturist | 36001 Euclid Ave, Suite B-7, Willoughby, OH 44094-4643 | 2011-05-04 |
| 1336464528 | Enlightened Health Management LLC | Pain Medicine | 36001 Euclid Ave, Willoughby, OH 44094-4643 | 2010-03-31 |
| 1063683662 | Main Street Medical Group, LLC | Internal Medicine | 36001 Euclid Ave, C-17, Willoughby, OH 44094-4643 | 2008-03-21 |
| 1134314644 | Russell Allen Blair | Internal Medicine | 36001 Euclid Ave, C19, Willoughby, OH 44094-4643 | 2007-09-07 |
| 1295929792 | Jennifer L Kriessler | Nurse Practitioner | 36001 Euclid Ave, C6, Willoughby, OH 44094-4643 | 2007-08-29 |
| 1871798801 | M H Phillip Chiang Md Inc | Family Medicine | 36001 Euclid Ave, B 4, Willoughby, OH 44094-4643 | 2007-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574367 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 36596 Euclid Ave, Willoughby, OH 44094 | 2020-09-25 |
| 1679111322 | Megan King | Nurse Practitioner | 4078 Erie Street, Unit B, Willoughby, OH 44094 | 2019-12-12 |
| 1124661525 | Mind and Body Infusion Therapies, LLC | Clinic/Center | 9264 Chillicothe Rd., Unit #2, Kirtland, OH 44094 | 2019-10-18 |
| 1679125637 | Christina Maria Chandler | Family Medicine | 39021 Signature Circle, Willoughby, OH 44094 | 2019-07-10 |
| 1467920595 | Rachel Curry | Specialist/Technologist | 53400 Euclid Ave., Apt. E-102, Willoughby, OH 44094 | 2018-11-07 |
| 1437649753 | Katie Lauren Greenaway | Registered Nurse | 5103 Robinhood Dr, Willoughby, OH 44094 | 2018-05-11 |
| 1003346131 | Heather Marie Hayes | Licensed Practical Nurse | 38882 Mentor Ave., Willoughby, OH 44094 | 2017-06-12 |
| 1609305028 | Ann Marie Mason | Counselor | 38882 Mentor Avenue, Willoughby, OH 44094 | 2017-06-08 |
| 1285173005 | Mattie Diann Towns-scott | Social Worker | 34950 Chardon Road, Bldg 2, Suite 210, Willoughby Hills, OH 44094 | 2017-02-13 |
| 1447797329 | Therese Benz | General Acute Care Hospital | 96000 Euclid Ave., Willoughby, OH 44094 | 2017-01-30 |
| Find all providers in zip 44094 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578662102 | Northeast Ohio Vascular Associates, Inc. | Surgery | 36060 Euclid Ave Ste 107, Willoughby, OH 44094-4661 | 2006-09-21 |
| 1639106594 | David Littleton Rollins | Surgery | 36060 Euclid Ave, Willoughby, OH 44094-4656 | 2006-06-27 |
| 1881637825 | Vikram K. Rao | Surgery | 36060 Euclid Ave, Willoughby, OH 44094-4656 | 2006-06-14 |
| 1366498636 | Mark Goldberg | Surgery | 36001 Euclid Ave, Suite B-6, Willoughby, OH 44094-4643 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659993459 | Matt Thompson | Surgery | Department of Vascular Surgery 9500 Euclid Avenue, Cleveland, OH 44195-0001 | 2020-05-14 |
| 1194373704 | Premier Vein and Vascular Care LLC | Surgery | 33290 Bainbridge Rd, Solon, OH 44139-2802 | 2019-08-27 |
| 1588144299 | Garcia Vascular Surgery Center, LLC | Surgery | 29099 Health Campus Dr Ste 380, Westlake, OH 44145-5276 | 2018-08-21 |
| 1962900365 | Marilyn Mcnamara | Surgery | 1031 Brook Ln, Rocky River, OH 44116-2184 | 2018-01-31 |
| 1386155521 | Zanesville Vascular Vein & Wound Center LLC | Surgery | 3964 Frazeysburg Rd Unit A, Zanesville, OH 43701-8920 | 2017-10-16 |
| 1679026751 | Center for Vein Restoration Oh, LLC | Surgery | 1050 Isaac Streets Dr Ste 131, Oregon, OH 43616-8203 | 2016-07-26 |
| 1235541640 | Jon Garrett Quatromoni | Surgery | Mail Code F30 9500 Euclid Avenue, Cleveland, OH 44195-4238 | 2014-05-20 |
| 1881035343 | Innovative Wound Care Associates, Inc | Surgery | 790 Boardman Canfield Rd Ste 3, Boardman, OH 44512-4344 | 2013-07-12 |
| 1184062242 | Jorge Enrique Motta | Surgery | 12268 Church Rd, Orrville, OH 44667-9623 | 2013-06-11 |
| 1912245853 | Cleveland East Vascular Care, LLC | Surgery | 23650 Commerce Park Ste B, Beachwood, OH 44122-5817 | 2013-01-28 |
| Find all providers with the same taxonomy | ||||
| City | WILLOUGHBY |
| Zip Code | 44094 |
Please comment or provide details below to improve the information on LAKE HOSPITAL SYSTEM, INC..
| 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.