Individual provider Active NPI

Gregory Lakin

  • Plastic Surgery Physician
  • Fort Lauderdale, FL
National Provider Identifier
1366455446
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
35.099884 Issued in OH
Practice address
6550 N Federal Hwy
Suite 320
Fort Lauderdale, FL 33308-1404
Phone
(954) 491-0510
Fax
(954) 491-1388
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A116423 CA
Plastic Surgery Physician 208200000X 35.099884 OH Primary
Plastic Surgery Physician 208200000X 496688 FL

Addresses

Primary practice location

6550 N Federal Hwy
Suite 320
Fort Lauderdale, FL 33308-1404

Mailing address

6550 N Federal Hwy
Suite 320
Fort Lauderdale, FL 33308-1404
Phone (954) 491-0510

Other identifiers 2

IdentifierTypeStateIssuer
0070344MedicaidOH
35.099884OtherOHLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
496688FLMDPlastic Surgery Physician
35.099884OHMDPlastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1366455446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 N FEDERAL HWY",
            "address_2": "SUITE 320",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081404",
            "telephone_number": "954-491-0510",
            "fax_number": "954-491-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 N FEDERAL HWY",
            "address_2": "SUITE 320",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081404",
            "telephone_number": "954-491-0510",
            "fax_number": "954-491-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKIN",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A116423",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "35.099884",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "496688",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070344",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "35.099884",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.