Ehs at Lakeside LLC
Organization Active NPI Hospitalist Physician · Belle Glade, FL
NPI 1275018673 · NPPES record last updated Oct 2, 2018
Key facts
- NPI
- 1275018673
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospitalist Physician 208M00000X
- Legal business name
- EHS AT LAKESIDE LLC
- Practice address
- 39200 Hooker Hwy
Belle Glade, FL 33430-5368 - Phone
- (561) 996-6571
- Fax
- (386) 274-7801
- NPI assigned
- Oct 2, 2018
- Organization subpart
- No
Authorized official
- Name
- Kenneth Scheppke, MD
- Title
- President
- Phone
- (561) 436-2291
Practitioners 17
-
Bryan M Dawkins, MD
-
Ishan A Gunawardene, M.D
-
Tamika Major, ARNP
-
Daila A. Cano, P.A.
-
Jesse Carl Grieb, DO
-
Michelle Joseph Isma, APRN
-
David Lepoff, DO
-
Willine Louis, APRN, FNP, PMHNP
-
Montia McIntosh, MSN, APRN-C, FAANP
-
Suzette Marshalyn Prendergast, NURSE PRACTITIONER
-
Varkey Abraham, PA
-
Jacob Putkowski, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190327002484 | FL | Part B Supplier - Clinic/Group Practice | 6901146067 |
Receives reassigned benefits from 16 practitioners Practice locations: Belle Glade, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician |
208M00000X | Yes |
Addresses
Primary practice location
39200 Hooker Hwy
Belle Glade, FL 33430-5368
Mailing address
PO Box 9414
Daytona Beach, FL 32120-9414
Phone (386) 274-7800
Other providers in Belle Glade, FL
- District Clinic Holdings Inc
- District Hospital Holdings Inc
- District Hospital Holdings Inc
- Audrey G. Dorsett
- Chaniya Dowers
- Ahmed El Guindi
- El Roble Assisted Living Facility Inc
- Elite Medical Services at Lakeside LLC
- Empowering Healthcare, LLC
- Kedner Etienne
All providers in Belle Glade, FL · Hospitalist Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.