Lake Meadows Licensee LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LAKE MEADOWS LICENSEE LLC

Doing business as

Lake Meadows Senior Assisted Living

Practice address

11570 E 126TH Street
Fishers, IN 46037

Phone

(260) 413-4159

NPI assigned

May 18, 2020

Organization subpart

No

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

Authorized official

Name

Ryan Person

Title

Director of Business Development

Phone

(260) 413-4159

Specialties & licenses 1

Addresses

Other names 1

• Lake Meadows Senior Assisted Living Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589760000000",
    "number": "1659994200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 ILLINOIS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11570 E 126TH STREET",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "46037",
            "telephone_number": "260-413-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MEADOWS LICENSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A",
        "authorized_official_last_name": "PERSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "260-413-4159"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Meadows Senior Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Estefania Laboy-Gonzalez
• Kristy Lynn Lacombe
• Ladd Dental of Fishers P.C.
• Brian Lahti, LSW
• Lauren Laird
• Aimee Lamartz, PHARMD
• Rowan Lamberson
• Nathan D Lambert, MD
• Robert Cole Lambert, DMD
• Caroline Lancaster

• Assisted Living Facility in Fishers, IN
• Providers in Fishers, IN by specialty
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.