COUNTY OF LAKE (NPI# 1376646380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376646380 |
| Entity Type | Organization |
| Organization Name | COUNTY OF LAKE |
| Other Organization Name | LAKE COUNTY PUBLIC HEALTH |
| Practice Address |
100 N D St Suite 100 Lakeview OR 97630-1540 |
| Practice Telephone | 5419476045 |
| Practice Fax Number | 5419474563 |
| Mailing Telephone | 5419476045 |
| Mailing Fax Number | 5419474563 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | MRS. MARY L WILKIE (ADMINISTRATOR) |
| Authorized Official Telephone | 5419476045 |
| Authorized Official Credential | RN, BSN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | 93-60023202 | OR | Agencies |
| N | 261QA0005X |
Clinic/Center Specialization: Ambulatory Family Planning Facility |
========= | OR | Ambulatory Health Care Facilities |
| N | 163WC1500X |
Registered Nurse Specialization: Community Health |
========= | OR | Nursing Service Providers |
| Y | 261QP0905X |
Clinic/Center Specialization: Public Health, State or Local |
========= | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OMAP FAMILY PLANNING PIN | 320989 | 01 |
| OR | BLUE CROSS PROVIDER NUMBE | 01358700 | 01 |
| OR | OMAP PROVIDERS | 320989 | 01 |
| OR | OMAP PIN | 097360 | 01 |
| Other Name | Type Code |
|---|---|
| Lake County Public Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477036507 | County of Lake | Community/Behavioral Health | 18736 W Peterson Rd, Libertyville, IL 60048-1064 | 2018-09-14 |
| 1093262867 | County of Lake | Clinic/Center | 15872 W 21st St, Wadsworth, IL 60083-8918 | 2016-09-08 |
| 1861857401 | County of Lake | Clinic/Center | 420 Greenwood Dr, Round Lake Park, IL 60073-3448 | 2015-12-28 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1639588254 | County of Lake | Clinic/Center | 800 High School Dr, Round Lake, IL 60073-2951 | 2014-08-07 |
| 1912333576 | County of Lake | Community/Behavioral Health | 18698 W Peterson Road, Libertyville, IL 60048 | 2013-09-16 |
| 1578861761 | County of Lake | Clinic/Center | 9345 Winchester St, Lower Lake, CA 95457-5000 | 2011-03-11 |
| 1528370277 | County of Lake | Community/Behavioral Health | 4118 Greenleaf Ct Apt 202, Park City, IL 60085-7913 | 2010-07-10 |
| 1619101292 | County of Lake | Clinic/Center | 2615 Washington Street, Waukegan, IL 60085 | 2009-05-11 |
| 1477721496 | County of Lake | Clinic/Center | 2424 Washington St, Waukegan, IL 60085-5074 | 2008-02-12 |
| Street Address |
100 N D ST SUITE 100 |
| City | LAKEVIEW |
| State | OR |
| Zip Code | 97630-1540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891186326 | Susan Ann Mungarro | Counselor | 215 North G Street, Lakeview, OR 97630 | 2015-02-05 |
| 1699183236 | Lake Health District | Clinic/Center | 700 South J St, Lakeview, OR 97630 | 2014-07-28 |
| 1912059569 | Howards Pharmacy Inc | Pharmacy | 101 North F St, Lakeview, OR 97630 | 2007-01-16 |
| 1316056120 | Michael Sabin Dmd PC | Dentist | 733 N 1st Street, Lakeview, OR 97630 | 2006-08-29 |
| 1174586564 | Donald Frank Ott | Nurse Anesthetist, Certified Registered | 700 S J, Lakeview, OR 97630 | 2006-04-08 |
| 1760922033 | Darrel Kyniston Kyniston | Counselor | 215 North G Street, Lakeview, OR 97630 | 2017-03-06 |
| 1518376722 | Lakeview Gardens LLC | Skilled Nursing Facility | 700 South J St, Lakeview, OR 97630 | 2014-08-13 |
| 1184935876 | Matthew Christopher Foster | Family Medicine | 700 S J St, Lakeview, OR 97630 | 2010-06-28 |
| 1457407264 | Angelyn Ray | Social Worker | 100 N. D Street, Office # 208 The Marius Building, Lakeview, OR 97630-0000 | 2007-01-25 |
| 1003823790 | Mary Juree Anderson | Registered Nurse | 530 Sunset, Lakeview, OR 97630-0032 | 2006-08-02 |
| Find all providers in zip 97630 | ||||
| Taxonomy Code | 261QP0905X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Public Health, State or Local |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669945713 | Lake Health District | Clinic/Center | 100 N D St Ste 100, Lakeview, OR 97630-1552 | 2019-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518405091 | The City of Newport 60 Plus Activity Center | Clinic/Center | 20 Se 2nd St, Newport, OR 97365 | 2017-02-06 |
| 1427196500 | Multnomah County | Clinic/Center | 5329 Ne Mlk Jr Blvd, Portland, OR 97211-3237 | 2007-02-02 |
| 1508904681 | Multnomah County | Clinic/Center | 6736 Ne Killingsworth St, Portland, OR 97218-3338 | 2007-02-02 |
| 1164451480 | County of Clatsop | Clinic/Center | 820 Exchange St, Suite 100, Astoria, OR 97103-4609 | 2006-06-30 |
| 1952302689 | County of Morrow | Clinic/Center | 120 S Main Street, Heppner, OR 97836 | 2005-08-03 |
| 1376900399 | Multnomah County | Clinic/Center | 12425 Ne Glisan St, Portland, OR 97230-2144 | 2016-01-21 |
| 1083081905 | Fred Meyer | Clinic/Center | 11565 Sw Pacific Hwy, Tigard, OR 97223-8845 | 2015-08-26 |
| 1417357443 | Multnomah County | Clinic/Center | 209 Sw 4th Ave, Portland, OR 97204-1813 | 2014-08-27 |
| 1881037281 | Public Health Foundation of Columbia County | Clinic/Center | 1005 Cougar St, Vernonia, OR 97064-1282 | 2013-04-16 |
| 1023451044 | Multnomah County | Clinic/Center | 619 Nw 6th Ave, Portland, OR 97209-3964 | 2013-04-09 |
| 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.