Lake Park Nursing & Rehab Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LAKE PARK NURSING & REHAB CENTER LLC

Practice address

259 SW Captain Brown Rd
Madison, FL 32340-4316

Phone

(270) 594-8700

NPI assigned

Dec 8, 2025

Organization subpart

No

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

Authorized official

Name

Moshe Kelman

Title

Member

Phone

(917) 613-1662

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1306709233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 SW CAPTAIN BROWN RD",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323404316"
        },
        {
            "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": "270-594-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PARK NURSING & REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "KELMAN",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-613-1662"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Charmaine Kennedy
• Tamera Reshonda King, BSN, RN
• Chase Knight
• Christopher Gabriel Krell, LPC
• L a D S Co. of North Florida
• Lake Park of Madison, LLC
• Lake Park Operations, LLC
• Logan G Langley, PA-C
• Richard Michael Laubaugh, M.D.
• Little Pine Pediatrics PLLC

• Skilled Nursing Facility in Madison, FL
• Providers in Madison, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.