NPIMap

Organization Active NPI

Lake Health

  • Registered Dietitian
  • Painesville, OH
National Provider Identifier
1134489677
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
6868 Issued in OH
Legal business name
LAKE HEALTH
Practice address
7580 Auburn Rd Ste 201
Painesville, OH 44077-9617
Phone
(440) 375-8153
Fax
(440) 375-8154
NPI assigned
May 17, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Sharon Jody Minjares, MS, RD, LD
Title
Directorlakehealthwellnessinstitute
Phone
(440) 350-4512

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0995640Lake Health Physician Group North7580 Auburn Road Suite 202, Concord, OH 44077Certificate of waiverOct 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Lake Medical Center37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

7580 Auburn Rd
Ste 201
Concord Township, OH 44077
Phone (440) 354-0944

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0febeb13-8e64-489b-8219-6b0ac5c29683/

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X 6868 OH Primary

Addresses

NPPES NPI Registry

Primary practice location

7580 Auburn Rd Ste 201
Painesville, OH 44077-9617

Mailing address

7580 Auburn Rd Ste 201
Painesville, OH 44077-9617
Phone (440) 375-8153

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 17, 2012.

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1134489677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 AUBURN RD STE 201",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779617",
            "telephone_number": "440-375-8153",
            "fax_number": "440-375-8154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 AUBURN RD STE 201",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779617",
            "telephone_number": "440-375-8153",
            "fax_number": "440-375-8154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "MINJARES",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "JODY",
        "authorized_official_title_or_position": "DIRECTORLAKEHEALTHWELLNESSINSTITUTE",
        "authorized_official_telephone_number": "440-350-4512",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "6868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.