SHANDS LAKE SHORE REGIONAL MEDICAL CENTER (NPI# 1962758342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962758342 |
| Entity Type | Organization |
| Organization Name | SHANDS LAKE SHORE REGIONAL MEDICAL CENTER |
| Practice Address |
368 Ne Franklin St Lake City FL 32055-3088 |
| Mailing Address |
8947 Abbington Dr Pensacola FL 32534-5347 |
| Practice Telephone | 3862928120 |
| Mailing Telephone | 8438600005 |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2012-08-03 |
| Authorized Official Name | MS. RHONDA SHARROD (CEO) |
| Authorized Official Telephone | 3862928120 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC2000X |
General Acute Care Hospital Specialization: Children |
ME112455 | FL | Hospitals |
| 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 |
| 1912410804 | Lake Shore Hma, LLC | Medicare Defined Swing Bed Unit | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2017-11-14 |
| 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 |
| 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 | 282NC2000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Children |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205193455 | Pediatric Emergency Medicine Department | General Acute Care Hospital | 10000 Sw 52nd Ave Apt 96, Gainesville, FL 32608-8335 | 2012-04-12 |
| 1275666364 | George Joseph Bennett | General Acute Care Hospital | 2628 Arbor Ln, Royal Palm Beach, FL 33411-6126 | 2007-03-14 |
| 1457991523 | Southern Baptist Hospital of Florida Inc | General Acute Care Hospital | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-01-07 |
| 1073962106 | Palms West Hospital | General Acute Care Hospital | 13001 Southern Blvd, Loxahatchee, FL 33470-9203 | 2016-06-09 |
| 1063877181 | All Children's Hospital | General Acute Care Hospital | 501 6th Ave S, St Petersburg, FL 33701-4634 | 2015-12-16 |
| 1619307667 | Usf Health | General Acute Care Hospital | 17 Davis Blvd, #200, Tampa, FL 33606-3475 | 2013-11-12 |
| 1932538089 | University of Florida | General Acute Care Hospital | 1600 Sw Archer Rd, B100296, Room Hd-513, Gainesville, FL 32610-3003 | 2013-11-08 |
| 1265867667 | Larkin Community Hospital | General Acute Care Hospital | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2013-09-05 |
| 1356694400 | Orlando Health | General Acute Care Hospital | 92 W Miller St, Attn: Picu, Orlando, FL 32806-2032 | 2012-10-25 |
| 1316293053 | Miami Children's Hospital | General Acute Care Hospital | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2012-07-31 |
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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.