Lakeside Memorial Hospital Inc.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

LAKESIDE MEMORIAL HOSPITAL INC.

Practice address

156 West Ave
Brockport, NY 14420-1229

Phone

(585) 395-6095

Fax

(585) 395-6036

NPI assigned

Sep 18, 2009

Organization subpart

Yes

Parent organization

LAKESIDE MEMORIAL HOSPITAL INC.As reported in NPPES

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

Authorized official

Name

Michael Stapleton

Title

Ceo

Phone

(585) 395-6095

Specialties & licenses 3

Addresses

Other names 1

• Lakeside Emergency Other name

Part of

Internal Medicine at Lakeside

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1609109925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201229",
            "telephone_number": "585-395-6095",
            "fax_number": "585-395-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201229",
            "telephone_number": "585-395-6095",
            "fax_number": "585-395-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MEMORIAL HOSPITAL INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKESIDE MEMORIAL HOSPITAL INC.",
        "enumeration_date": "2009-09-18",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "STAPLETON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "585-395-6095"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Emergency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lakeside Health System Medical Services
• Lakeside Hospital Internal Medicine Group
• Lakeside Imaging, LLC
• Lakeside Memorial Hospital Inc (Lakeside Memorial Hosp Phcy Inc)
• Lakeside Memorial Hospital Inc.
• Lakeside Memorial Hospital Inc.
• Lakeside Memorial Hospital Inc.
• Lakeside Memorial Hospital Inc.
• Lakeside Memorial Hospital Inc.
• Lakeside Memorial Hospital Inc.

• Emergency Medicine Physician in Brockport, NY
• Providers in Brockport, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.