Lakeside Youth N Kids Pediatrics

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

50291 Issued in CO

Legal business name

LAKESIDE YOUTH N KIDS PEDIATRICS

Practice address

6055 W 46TH Ave
Wheat Ridge, CO 80033-1811

Phone

(916) 300-7534

NPI assigned

Sep 25, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Lance Jesse Lazatin, M.D.NPI 1215127311

Title

Physician/Owner

Phone

(916) 300-7534

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

Practitioners 5

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

• Lance J Lazatin, M.D.

  • Pediatrics Physician
  • Wheat Ridge, CO
  • NPI 1215127311
  NPD (past) Authorized official
• Holly Benz

  • Pediatrics Physician
  • Wheat Ridge, CO
  • NPI 1447678230
  NPD (past)
• Amy B. Lannigan, M.D.

  • Pediatrics Physician
  • Wheat Ridge, CO
  • NPI 1942228762
  NPD (past)
• Carolyn Dinsdale Prather, MSN, APRN, FNP-BC

  • Nurse Practitioner
  • Wheat Ridge, CO
  • NPI 1780220111
  NPD (past)
• Sandra Jeanne Symes-Gilbert, NP

  • Pediatric Nurse Practitioner
  • Wheat Ridge, CO
  • NPI 1437216033
  NPD (past)

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1275903833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 W 46TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800331811",
            "telephone_number": "916-300-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 W 46TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800331811",
            "telephone_number": "916-300-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE YOUTH N KIDS PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "LAZATIN",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "JESSE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "916-300-7534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "50291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63008564",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaymaree Lusk Labossiere
• John Labuda
• Glen Alan Lacher, LDC CACTT
• Iasmin Souza Lafleur
• Deserie Laforett
• Eric James Lakey, MD
• Chun Kei Edward Lam
• William Schuyler Lamm, PT, DPT
• Jane Ann Landis, M.A.
• Tish R Landrum, MD

• Primary Care Clinic/Center in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.