NPIMap

Organization Active NPI

Lake Shore Hma, LLC

  • General Acute Care Hospital
  • Lake City, FL
National Provider Identifier
1386743045
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
4258 Issued in FL
Legal business name
LAKE SHORE HMA, LLC
Practice address
368 NE Franklin St
Lake City, FL 32055-3088
Phone
(386) 754-8000
Fax
(352) 733-0069
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Authorized official

Name
Paula M Lalor
Title
Director/Delegated Official
Phone
(615) 925-4565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 4258 FL Primary

Addresses

Primary practice location

368 NE Franklin St
Lake City, FL 32055-3088

Mailing address

368 NE Franklin St
Lake City, FL 32055-3088
Phone (386) 754-8000

Other identifiers 1

IdentifierTypeStateIssuer
010033100MedicaidFL

Other names 1

  • Shands Lake Shore Regional Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wallace Owens Crna2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520553600000",
    "number": "1386743045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 NE FRANKLIN ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320553088",
            "telephone_number": "386-754-8000",
            "fax_number": "352-733-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 NE FRANKLIN ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320553088",
            "telephone_number": "386-754-8000",
            "fax_number": "352-733-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SHORE HMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2018-03-09",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "615-925-4565"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "4258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010033100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shands Lake Shore Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; 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.