LAKEVIEW MEDICAL GROUP INC (NPI# 1972721025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972721025 |
| Entity Type | Organization |
| Organization Name | LAKEVIEW MEDICAL GROUP INC |
| Practice Address |
830 Waterbury Falls Dr Ste 202 O Fallon MO 63368-2215 |
| Mailing Address |
830 Waterbury Falls Dr Ste 202 O Fallon MO 63368-2215 |
| Practice Telephone | 6362781670 |
| Mailing Telephone | 6363974012 |
| Mailing Fax Number | 6362781670 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2017-03-17 |
| Authorized Official Name | THOMAS WRIGHT (PRESIDENT) |
| Authorized Official Telephone | 6363974012 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 108025 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE GROUP PTAN | 000013627 | 01 |
| Street Address |
830 WATERBURY FALLS DR STE 202 |
| City | O FALLON |
| State | MO |
| Zip Code | 63368-2215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417935974 | Thomas F Wright | Family Medicine | 830 Waterbury Falls Dr, Ste 202, O Fallon, MO 63368-2215 | 2006-01-05 |
| 1447472519 | Midwest Special Surgery, P.C. | Surgery | 830 Waterbury Falls Dr, O Fallon, MO 63368-2215 | 2007-05-02 |
| 1710009550 | Outpatient Surgery Services | Surgery | 830 Waterbury Falls Dr, O Fallon, MO 63368-2215 | 2007-04-04 |
| 1184779399 | Tony E Sudekum | Surgery | 830 Waterbury Falls Dr, O Fallon, MO 63368-2215 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417307505 | Kent Alexander Neil Cassmeyer | Internal Medicine | 300 Winding Woods Dr Ste 214, O Fallon, MO 63366-4773 | 2016-06-20 |
| 1245453844 | Amy Kathleen Davis | Internal Medicine | 1008 Rock Creek Elementary School Dr, O Fallon, MO 63366-7576 | 2007-04-11 |
| 1124166434 | Progress West Healthcare Center | Internal Medicine | Two Progress Point Parkway, O Fallon, MO 63368 | 2007-02-01 |
| 1689640609 | Geraldine A. Ryan | Internal Medicine | 9426 Phoenix Village Pkwy, O Fallon, MO 63368-4781 | 2006-02-28 |
| 1750377941 | Gregory P Genova | Internal Medicine | 5551 Winghaven Blvd Ste 250, O Fallon, MO 63368-3630 | 2005-09-22 |
| 1720587918 | Cep America-illinois Hospitalists, LLP | Internal Medicine | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2018-02-02 |
| 1154777597 | Isaac Tran | Internal Medicine | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2016-05-04 |
| 1396142139 | Pc Associates, LLC | Internal Medicine | 310 N Seven Hills Rd, O Fallon, IL 62269-4111 | 2014-11-21 |
| 1295155000 | Genevieve Catherine Matthews | Internal Medicine | 20 Progress Point Pkwy Ste 108, O Fallon, MO 63368-2207 | 2014-04-18 |
| 1326380908 | Seema Verma | Internal Medicine | 1 Saint Elizabeth Blvd, O Fallon, IL 62269 | 2013-03-21 |
| Find all providers in O FALLON | ||||
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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.