LAKE INTERNAL MED SPECIAL (NPI# 1275719627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275719627 |
| Entity Type | Organization |
| Organization Name | LAKE INTERNAL MED SPECIAL |
| Practice Address |
980 Executive Dr Suite D Osage Beach MO 65065-3495 |
| Practice Telephone | 5733486700 |
| Practice Fax Number | 5733483310 |
| Mailing Telephone | 5733486700 |
| Mailing Fax Number | 5733483310 |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |
| Authorized Official Name | DR. M DAVID EAST (OWNER) |
| Authorized Official Telephone | 5733486700 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
RIE24 | MO | Ambulatory Health Care Facilities |
| Street Address |
980 EXECUTIVE DR SUITE D |
| City | OSAGE BEACH |
| State | MO |
| Zip Code | 65065-3495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778859 | Suzanne Marie Harris | Social Worker | 1191 State Highway Kk, Suite 101, Osage Beach, MO 65065 | 2020-04-15 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1245723337 | William T Mcfail | Counselor | 1191 State Hwy Kk, Suite 101, Osage Beach, MO 65065 | 2018-06-13 |
| 1588102263 | Jennifer Kiske | Physical Therapist | 5780 Osage Beach Parkway, Ste 220, Osage Beach, MO 65065 | 2017-02-02 |
| 1700207586 | Brenda Renee Spies | Pharmacist | 4252 Osage Beach Parkway, Osage Beach, MO 65065 | 2013-12-23 |
| 1154668465 | Paige Hedgpath Od, PC | Optometrist | 4645g Osage Beach Parkway, Osage Beach, MO 65065 | 2013-01-07 |
| 1649548330 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 300 Kestrel Lane, Lake Ozark, MO 65065 | 2011-12-08 |
| 1437399821 | Melissa Nicole Morgan | Physical Therapy Assistant | 5177 Vicus Castri, Osage Beach, MO 65065 | 2009-02-25 |
| 1730330911 | Raymond Don Baker | Preventive Medicine | 5476 Stone Ledge Cir, Osage Beach, MO 65065 | 2008-10-06 |
| 1457514259 | Lake Family Dentistry | Dentist | 1037 Palisades Blvd Ste 9, Osage Beach, MO 65065 | 2008-07-02 |
| Find all providers in zip 65065 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536818 | Heartland Weight Loss Clinic, LLC | Clinic/Center | 3095 Lexington Ave Ste 200, Cape Girardeau, MO 63701-2629 | 2020-10-23 |
| 1902361652 | Redings Mill Internal Care | Clinic/Center | 454 Redings Mill Rd, Joplin, MO 64804 | 2019-02-06 |
| 1386126308 | Kirksville Specialty Clinic LLC | Clinic/Center | 1108 E Patterson St Ste 10, Kirksville, MO 63501-4043 | 2018-09-06 |
| 1639616113 | Stratus Medical Group | Clinic/Center | 2010 N Main St, Sikeston, MO 63801-8478 | 2017-01-23 |
| 1871044735 | Susan D Purcell Md Dermatology LLC | Clinic/Center | 969 N Mason Rd Ste 170, Saint Louis, MO 63141-6387 | 2016-10-16 |
| 1679961577 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr Ste 130, Jefferson City, MO 65109-9508 | 2014-12-30 |
| 1407251069 | Missouri Cvs Pharmacy, L.L.C. | Clinic/Center | 942 Valley Creek Dr, Farmington, MO 63640-1968 | 2014-10-24 |
| 1154730414 | Mohammed Z Siddiqui Medical Consulting LLC | Clinic/Center | 10 Overbrook Dr, Saint Louis, MO 63124-1482 | 2014-08-11 |
| 1962818435 | Retired | Clinic/Center | 13714 N Sportsmans Dr, Hallsville, MO 65255-9330 | 2014-07-06 |
| 1043625460 | Kobler Chiropractic and Acupuncture LLC | Clinic/Center | 500 Nw Englewood Rd, Kansas City, MO 64118-3960 | 2014-06-24 |
| Find all providers with the same taxonomy | ||||
| City | OSAGE BEACH |
| Zip Code | 65065 |
Please comment or provide details below to improve the information on LAKE INTERNAL MED SPECIAL.
| 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.