Active NPI
Lake Park of Madison, LLC
Doing business as Lake Park of Madison
- Skilled Nursing Facility
- Madison, FL
National Provider Identifier
1184876914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- SNF16360961
- Legal business name
- LAKE PARK OF MADISON, LLC
- Doing business as
- Lake Park of Madison
- Practice address
- 259 SW Captain Brown Rd
Madison, FL 32340-4316 - Phone
- (850) 973-8277
- Fax
- (850) 973-4006
- NPI assigned
- Oct 10, 2008
- Last updated
- Oct 10, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Steven D Womack
- Title
- Managing Member
- Phone
- (828) 324-8898
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF16360961 | FL | Primary |
Addresses
Primary practice location
259 SW Captain Brown Rd
Madison, FL 32340-4316
Mailing address
PO Box 3343
Hickory, NC 28603-3343
Phone (828) 324-8898
Other names 1
- Lake Park of Madison
National Provider Directory
National Provider Directory- Tax ID family
- Lafayette Health Care Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Lafayette Health Care Center
- Skilled Nursing Facility
- Mayo, FL
- NPI 1558513382
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223596800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1223596800000",
"number": "1184876914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3343",
"city": "HICKORY",
"state": "NC",
"postal_code": "286033343",
"telephone_number": "828-324-8898",
"fax_number": "828-322-9598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 SW CAPTAIN BROWN RD",
"city": "MADISON",
"state": "FL",
"postal_code": "323404316",
"telephone_number": "850-973-8277",
"fax_number": "850-973-4006"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKE PARK OF MADISON, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-10",
"last_updated": "2008-10-10",
"status": "A",
"authorized_official_last_name": "WOMACK",
"authorized_official_first_name": "STEVEN",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "828-324-8898",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "FL",
"license": "SNF16360961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lake Park of Madison",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Madison, FL
- Tamera Reshonda King, BSN, RN
- Chase Knight
- Christopher Gabriel Krell, LPC
- L a D S Co. of North Florida (Norris Medical Compounding Lab)
- Lake Park Nursing & Rehab Center LLC
- Lake Park Operations, LLC
- Logan G Langley, PA-C
- Richard Michael Laubaugh, M.D.
- Little Pine Pediatrics PLLC (Little Pine Pediatrics of Madison)
- Little Pine Pediatrics, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.