LAKESIDE FAMILY MEDICINE (NPI# 1720514029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720514029 |
Entity Type | Organization |
Organization Name | LAKESIDE FAMILY MEDICINE |
Practice Address |
104 Carrington Park Dr Ste B Gainesville GA 30504-6603 |
Practice Telephone | 7708993773 |
Mailing Telephone | 7708993773 |
Enumeration Date | 2017-05-04 |
Last Update Date | 2017-05-04 |
Authorized Official Name | FOROOGH NARMANI-MOHAMMADI (FAMILY NURSE PRACTITIONER) |
Authorized Official Telephone | 7708993773 |
Authorized Official Credential | DNP, FNP-C |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
F0514016 | GA | Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790188639 | Lakeside Family Medicine | Family Medicine | 714 Hwy 70 E, Kingston, OK 73439 | 2014-10-07 |
1295064178 | Lakeside Family Medicine | Family Medicine | 21 N. Main Street, Kingston, OK 73439-1798 | 2009-12-23 |
Street Address |
104 CARRINGTON PARK DR STE B |
City | GAINESVILLE |
State | GA |
Zip Code | 30504-6603 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447659347 | Foroogh Narmani-mohammadi | Nurse Practitioner | 104 Carrington Park Dr Ste B, Gainesville, GA 30504-6603 | 2014-08-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174124572 | Jessica Rodriguez New | Pharmacist | 2892 Browns Bridge Road, Gainesville, GA 30504 | 2020-11-03 |
1710541461 | Lauren Brooke Taylor | Occupational Therapist | 2900 Mcever Road, Gainesville, GA 30504 | 2019-04-29 |
1801023700 | Brenda Levartha Hamilton | Registered Nurse | 3905 Mabry Rd., Gainesville, GA 30504 | 2009-06-18 |
1083757645 | Charles Kent Yarbrough | Optometrist | 400 Shallowford Road, Vision Center, Gainesville, GA 30504 | 2007-02-14 |
1881746170 | Lisa S. Ralston | Occupational Therapist | 3038 St. Charles Ave., 3038 St. Charles Ave., Gainesville, GA 30504 | 2007-01-17 |
1326140690 | David Richards Adamson | Physical Therapist | 3640 Mundy Mill Road, Suite 102b, Oakwood, GA 30504 | 2006-09-05 |
1326057621 | Henry Joseph Lewis IIi | Legal Medicine | 5606 Captains Ct, Gainesville, GA 30504 | 2006-08-05 |
1992164032 | Hall County Endoscopy Center LLC | Clinic/Center | 1955 Textile Way, Gainesville, GA 30504 | 2016-02-17 |
1982902276 | James Minton | Pharmacist | 3640 Mundy Mill Road, Gainesville, GA 30504 | 2011-03-10 |
1881758969 | Donna Marie Colavecchio | Occupational Therapy Assistant | 3640 Mundy Mill Road, Suite 102b, Oakwood, GA 30504 | 2006-12-21 |
Find all providers in zip 30504 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649811928 | Careatc | Clinic/Center | 1314 W Ridge Rd, Gainesville, GA 30501-6932 | 2019-10-08 |
1982143079 | Celebrate Primary Care | Clinic/Center | 4400 Nw 23rd Ave Ste B, Gainesville, FL 32606-6562 | 2017-02-22 |
1588054415 | Dr. Stephen Ellis Landay | Clinic/Center | 7109 Nw 11th Pl Ste E, Gainesville, FL 32605-3141 | 2015-01-30 |
1053747188 | Pediatrics & Family Medicine of Buena Vista, LLC | Clinic/Center | 10552 Nw 13th Ave, Gainesville, FL 32606-8088 | 2013-09-20 |
1558606335 | Primary Care of Gainesville LLC | Clinic/Center | 1026 Sw 2nd Ave Ste C, Gainesville, FL 32601-8182 | 2012-12-04 |
1780709998 | Innocent Odocha Md Pa | Clinic/Center | 816 Nw 13th St, Gainesville, FL 32601-2903 | 2007-03-20 |
1164443255 | Shamal D Nadkarni Md Pa | Clinic/Center | 1026 Sw 2nd Ave, Suite D, Gainesville, FL 32601-6134 | 2006-07-22 |
1538794326 | Psk Management LLC | Clinic/Center | 1364 Nw 121st Way, Gainesville, FL 32606-5274 | 2020-03-12 |
1124478078 | Prosalud Medical Center | Clinic/Center | 1870 Atlanta Rd, Ste J, Gainesville, GA 30504-5948 | 2016-06-21 |
1124441241 | Jones Family Medical, Pllc | Clinic/Center | 413 E Broadway St, Gainesville, TX 76240-4169 | 2014-01-24 |
Find all providers in GAINESVILLE |
City | GAINESVILLE |
Zip Code | 30504 |
Please comment or provide details below to improve the information on LAKESIDE FAMILY MEDICINE.
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.