LAKE REGIONAL HEALTH SYSTEM (NPI# 1437440856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437440856 |
| Entity Type | Organization |
| Organization Name | LAKE REGIONAL HEALTH SYSTEM |
| Other Organization Name | LAKE REGIONAL CLINIC - CAMDENTON |
| Practice Address |
1930 N Business Route 5 Unit 1a Camdenton MO 65020-2659 |
| Mailing Address |
Po Box 1500 Osage Beach MO 65065-1500 |
| Practice Telephone | 5733465624 |
| Practice Fax Number | 5733461957 |
| Mailing Telephone | 5733488074 |
| Mailing Fax Number | 5733488069 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2015-08-10 |
| Authorized Official Name | DAVID W. HALSELL (SR. V.P. CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5733488388 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1437440856 | 05 |
| Other Name | Type Code |
|---|---|
| Lake Regional Clinic - Camdenton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346530797 | Lake Regional Health System | Clinic/Center | 14298 W Us Highway 54, Macks Creek, MO 65786-6730 | 2011-04-19 |
| 1427162254 | Lake Regional Health System | Clinic/Center | 156 Missouri Boulevard, Suite B, Laurie, MO 65038-4933 | 2006-08-18 |
| 1740255520 | Lake Regional Health System | Home Health | 1193 Highway Kk, Ste C, Osage Beach, MO 65065-3344 | 2006-02-23 |
| 1548743412 | Lake Regional Health System | Clinic/Center | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2018-09-07 |
| 1417492091 | Lake Regional Health System | Hospice Care, Community Based | 1193 Highway Kk, Osage Beach, MO 65065-3344 | 2017-01-05 |
| 1962828616 | Lake Regional Health System | Family Medicine | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2014-03-05 |
| 1295151959 | Lake Regional Health System | General Acute Care Hospital | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2014-03-05 |
| 1679997407 | Lake Regional Health System | Durable Medical Equipment & Medical Supplies | 54 Hospital Dr, Suite 201, Osage Beach, MO 65065-3050 | 2014-02-14 |
| 1376883843 | Lake Regional Health System | Durable Medical Equipment & Medical Supplies | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2013-02-21 |
| 1700177128 | Lake Regional Health System | Clinic/Center | 1870 Bagnell Dam Blvd, Lake Ozark, MO 65049-8658 | 2011-04-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LAKE REGIONAL HEALTH SYSTEM | 54 Hospital Dr, Osage Beach, MO 65065-3050 |
| Street Address |
1930 N BUSINESS ROUTE 5 UNIT 1A |
| City | CAMDENTON |
| State | MO |
| Zip Code | 65020-2659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477552479 | Michael H Ledbetter | Family Medicine | 1930 N Business Route 5, Unit 1a, Camdenton, MO 65020-2659 | 2005-07-20 |
| 1194257378 | Michelle Alane Helton | Family Medicine | 1930 N Business Route 5, Camdenton, MO 65020-2659 | 2017-03-28 |
| 1669775771 | Robert Oliver Meyer | Nurse Practitioner | 1930 N Business Route 5, Unit 1a, Camdenton, MO 65020-2659 | 2010-12-10 |
| 1013181601 | James J.l. Neill | Family Medicine | 1930 N Business Route 5, Unit 1a, Camdenton, MO 65020-2659 | 2008-04-15 |
| 1548434384 | Shari Leuwerke Neill | Pediatrics | 1930 N Business Route 5, Unit 1a, Camdenton, MO 65020-2659 | 2008-04-14 |
| 1326005190 | Micheal J Durham | Family Medicine | 1930 N Business Route 5, Unit 1a, Camdenton, MO 65020-2659 | 2006-04-27 |
| 1376515080 | Debra A Atkinson | Family Medicine | 1930 N Business Route 5, Unit 1a, Camdenton, MO 65020-2659 | 2006-02-06 |
| 1013997493 | Linda S Jabbari | Family Medicine | 1930 N Business Route 5, Unit 1a, Camdenton, MO 65020-2659 | 2006-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295383024 | Carinda Elynn Steele | Physical Therapy Assistant | 1930 N Business 5, Camdenton, MO 65020 | 2019-08-26 |
| 1831651660 | Erin Elisabeth Sluyter | Physician Assistant | 1652 North Business Route 5, Camdenton, MO 65020 | 2019-04-01 |
| 1922575125 | Serene Shores, LLC | Counselor | 75 Court Circle Se, Camdenton, MO 65020 | 2018-10-26 |
| 1902396591 | Audrey Dawn Sheppard | Counselor | 89 Mccrory Dr, Camdenton, MO 65020 | 2018-05-18 |
| 1427586072 | Abc Laurie LLC | Chiropractor | 139 E Hwy 54 Suite 1c, Camdenton, MO 65020 | 2017-05-26 |
| 1891229878 | Benton Street Counseling LLC | Counselor | 89 Mccrory Drive, Camdenton, MO 65020 | 2017-04-17 |
| 1033658463 | Erica L Asbell | Social Worker | 172 Dare Blvd., Camdenton, MO 65020 | 2017-02-17 |
| 1376816967 | Linda Susan Sheriff | Speech-Language Pathologist | 158 Minor Street, Camdenton, MO 65020 | 2012-02-14 |
| 1285902031 | Gregory Ryan Boren | Pharmacist | 72 South Business Route 5, Camdenton, MO 65020 | 2011-12-08 |
| 1265757033 | Abcs of Wellness, LLC | Chiropractor | 139 E. Hwy 54, 1c, Camdenton, MO 65020 | 2010-04-05 |
| Find all providers in zip 65020 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
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| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| 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.