NPIMap

Organization Active NPI

Lakeshore Health PLLC

  • Internal Medicine Physician
  • Sandpoint, ID
National Provider Identifier
1487380655
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LAKESHORE HEALTH PLLC
Practice address
102 S Euclid Ave Ste 202
Sandpoint, ID 83864-4939
Phone
(208) 906-2525
NPI assigned
Jul 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Dr. Megan Skibitsky, MDNPI 1801039730
Title
Ownder
Phone
(208) 906-2525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

102 S Euclid Ave Ste 202
Sandpoint, ID 83864-4939

Mailing address

351 S Jacobson Rd
Sandpoint, ID 83864-6551
Phone (385) 290-5363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221011001370 ID Part B Supplier - Clinic/Group Practice 6800262197 Receives reassigned benefits from 1 practitioner
Practice locations: Sandpoint, ID

National Provider Directory

National Provider Directory

Locations

409 Church St
Sandpoint, ID 83864
Phone (208) 906-2525

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1487380655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 S JACOBSON RD",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838646551",
            "telephone_number": "385-290-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S EUCLID AVE STE 202",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838644939",
            "telephone_number": "208-906-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "SKIBITSKY",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OWNDER",
        "authorized_official_telephone_number": "208-906-2525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.