Lakeside Family Practice PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LAKESIDE FAMILY PRACTICE PLLC

Practice address

933 Cheat Rd
Morgantown, WV 26508-5631

Phone

(304) 594-2400

Fax

(304) 594-2256

NPI assigned

Oct 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brian W Hawthorne, M.D.

Title

President

Phone

(304) 594-2400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

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

• Robin W Garrett, D.O.

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1649251687
  NPD (past)
• Lydia Smith, FNP-BC

  • Family Nurse Practitioner
  • Scott Depot, WV
  • NPI 1235415217
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1205919917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 CHEAT RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265085631",
            "telephone_number": "304-594-2400",
            "fax_number": "304-594-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 CHEAT RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265085631",
            "telephone_number": "304-594-2400",
            "fax_number": "304-594-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "HAWTHORNE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-594-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP PROVIDE",
            "identifier": "001709238",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002243",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Mackenzie Lafferty, MS
• Sarah Elizabeth Lago, D.O.
• Janet Taylor Laguardia, LPC
• Lingo Y. Lai, M.D.
• Erica Renee Lakas, PHARMD.
• Dhairya A Lakhani, MD
• Emily Lam, MD
• Wing Christine Lam, O.D.
• Tiffany Lamar
• Gabriel Thomas Lamb

• Family Medicine Physician in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.