PHYSICIANS IMAGING -- LAKE CITY LLC (NPI# 1588855027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588855027 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS IMAGING -- LAKE CITY LLC |
| Practice Address |
404 Nw Hall of Fame Dr Lake City FL 32055-4833 |
| Practice Telephone | 3864873970 |
| Practice Fax Number | 3864873972 |
| Mailing Telephone | 3864873970 |
| Mailing Fax Number | 3864873972 |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2008-06-26 |
| Authorized Official Name | DR. ELIAS J GERTH (CEO) |
| Authorized Official Telephone | 3523838800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
HCC7889 | FL | Ambulatory Health Care Facilities |
| Street Address |
404 NW HALL OF FAME DR |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-4833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194713727 | Pamela Nichols Robinson | Nurse Anesthetist, Certified Registered | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2005-10-07 |
| 1902466881 | Samantha Andersen Smythe | Nurse Practitioner | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2019-06-13 |
| 1063975175 | Cardiovascular Center of America | Surgery | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2019-04-08 |
| 1851808224 | Cassie Ebert | Internal Medicine | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2018-01-06 |
| 1053851451 | Elaina Williamson | Nurse Practitioner | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2017-03-03 |
| 1457899577 | Jordan Cunningham | Nurse Practitioner | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2017-02-09 |
| 1013303254 | Therapycare Home Health LLC | Home Health | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2015-04-14 |
| 1437553161 | Bryce Catarelli | Nurse Practitioner | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2014-10-09 |
| 1477982882 | Brandon Johnson | Physical Therapy Assistant | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2013-11-06 |
| 1568890663 | Brian Sganga | Physical Therapy Assistant | 404 Nw Hall of Fame Dr, Lake City, FL 32055-4833 | 2013-10-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972596450 | Clinical Pet of Lake City | Clinic/Center | 484 Sw Commerce Dr, Suite 145, Lake City, FL 32025-1507 | 2005-08-30 |
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| 1609422146 | Dis of Tampa Bay Inc | Clinic/Center | 3635 W Waters Ave, Tampa, FL 33614-2783 | 2019-08-12 |
| 1245891209 | Ohri, LLC | Clinic/Center | 392 Rinehart Rd., Suite 1300, Lake Mary, FL 32746 | 2019-06-21 |
| 1417518481 | Ohri, LLC | Clinic/Center | 5151 Winter Garden Vineland Road., Suite 104, Windermere, FL 34786 | 2019-06-21 |
| 1093273971 | Alfa Diagnostic LLC | Clinic/Center | 21355 E Dixie Hwy Ste 107, Aventura, FL 33180-1239 | 2019-03-09 |
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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.