NPIMap

Organization Active NPI

Lake Erie College of Osteopathic Medicine, Inc.

  • General Practice Dentistry
  • Erie, PA
National Provider Identifier
1497448724
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, INC.
Practice address
5515 Peach St
Erie, PA 16509-2603
Phone
(814) 868-8258
NPI assigned
Jun 1, 2023
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Steven Gregory Inman
Title
VP Fiscal Affairs/Cfo
Phone
(814) 868-8258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5515 Peach St
Erie, PA 16509-2603

Mailing address

2000 W Grandview Blvd
Erie, PA 16509-1029
Phone (814) 868-1030

Other names 1

  • LECOM Dental Office at MCH Other name

National Provider Directory

National Provider Directory
Tax ID family
Lake Erie College of Osteopathic Medicine Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1497448724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W GRANDVIEW BLVD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091029",
            "telephone_number": "814-868-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-868-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "INMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "VP FISCAL AFFAIRS/CFO",
        "authorized_official_telephone_number": "814-868-8258"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LECOM Dental Office at MCH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.