LAKE SHORE HMA, LLC (NPI# 1912410804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912410804 |
| Entity Type | Organization |
| Organization Name | LAKE SHORE HMA, LLC |
| Other Organization Name | SHANDS LAKE SHORE REGIONAL MEDICAL CENTER |
| Practice Address |
368 Ne Franklin St Lake City FL 32055-3088 |
| Practice Telephone | 3862928000 |
| Practice Fax Number | 3867958369 |
| Mailing Telephone | 3862928000 |
| Mailing Fax Number | 3867958369 |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |
| Authorized Official Name | PAULA LALOR (DIRECTOR/ DELEGATED OFFICIAL) |
| Authorized Official Telephone | 6159254565 |
| Is Organization Subpart | Y |
| Parent Organization Name | LAKE SHORE HMA, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 4268 | FL | Hospital Units |
| Other Name | Type Code |
|---|---|
| Shands Lake Shore Regional Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386743045 | Lake Shore Hma, LLC | General Acute Care Hospital | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2006-09-21 |
| Street Address |
368 NE FRANKLIN ST |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-3088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457396434 | Paul Richard Schriever | Emergency Medicine | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2006-06-17 |
| 1295270007 | Columbia Emergency Group LLC | Physician Assistant | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2017-01-03 |
| 1023428539 | Bobbie Lee Rodgers | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2014-05-06 |
| 1821417502 | Stephen Helvey | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2014-04-10 |
| 1770902512 | Gregory A Dyle | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2014-04-09 |
| 1962758342 | Shands Lake Shore Regional Medical Center | General Acute Care Hospital | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2012-08-03 |
| 1346500949 | Foremost Anesthesia Staffing LLC | Anesthesiology | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2012-05-17 |
| 1821317579 | Sergio Bustos Munoz | Pediatrics | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2010-05-20 |
| 1447572037 | Crystal Anne Ferwerda | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2010-02-23 |
| 1912179227 | Christie Elaine Kennedy | Nurse Practitioner | 368 Ne Franklin St, Lake City, FL 32055 | 2008-03-26 |
| 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 | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790850865 | Lower Florence County Hospital | Medicare Defined Swing Bed Unit | 258 N Ron Mcnair Blvd, Lake City, SC 29560-2462 | 2006-11-22 |
| 1891710893 | Mayo Clinic Health System-lake City | Medicare Defined Swing Bed Unit | 500 W Grant St, Lake City, MN 55041-1143 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992299051 | Debonair Furnishings, LLC | Medicare Defined Swing Bed Unit | 12355 Ne 13th Ave Ste 400, North Miami, FL 33161-5971 | 2018-06-21 |
| 1144535204 | Pulmonary Physicians of South Florida | Medicare Defined Swing Bed Unit | 15680 N Kendall Dr Ste 201, Miami, FL 33196-1160 | 2010-08-13 |
| 1083684856 | Madison County Hospital Health Systems, Inc. | Medicare Defined Swing Bed Unit | 224 Nw Crane Avenue, Madison, FL 32340-1400 | 2006-01-25 |
| 1518941806 | Mariners Hospital Inc | Medicare Defined Swing Bed Unit | 91500 Overseas Hwy, Tavernier, FL 33070-2547 | 2005-12-01 |
| 1700495389 | Naples Hma LLC | Medicare Defined Swing Bed Unit | 6101 Pine Ridge Rd, Naples, FL 34119-3900 | 2020-07-29 |
| 1043837297 | Key West Hma LLC | Medicare Defined Swing Bed Unit | 5900 College Rd, Key West, FL 33040-4342 | 2020-07-02 |
| 1770100349 | Hernando Hma LLC | Medicare Defined Swing Bed Unit | 17240 Cortez Blvd, Brooksville, FL 34601-8921 | 2020-06-30 |
| 1346863503 | Citrus Hma LLC | Medicare Defined Swing Bed Unit | 6201 N Suncoast Blvd, Crystal River, FL 34428-6712 | 2020-05-22 |
| 1144843392 | Osceolasc LLC | Medicare Defined Swing Bed Unit | 2906 17th St, Saint Cloud, FL 34769-6006 | 2020-05-22 |
| 1932722188 | Venice Hma LLC | Medicare Defined Swing Bed Unit | 540 The Rialto, Venice, FL 34285-2900 | 2020-05-22 |
| 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.