Lakeside Holistic Health, PLLC

Primary specialty

NaturopathTaxonomy code 175F00000X

License

NT00001257 Issued in WA

Legal business name

LAKESIDE HOLISTIC HEALTH, PLLC

Practice address

518 North 4TH Street
Coeur D'Alene, ID 83814

Phone

(208) 758-0568

Fax

(208) 765-4660

NPI assigned

May 29, 2012

Last updated

May 29, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry Lee Bailey II, DC, CAC

Title

Owner/Partner

Phone

(208) 758-0568

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pamela Sue Langenderfer, N.M.D, M.S.O.M., LAC

  • Naturopath
  • Coeur d'Alene, ID
  • NPI 1407912470

  Acupuncturist

  NPD (past)

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338249600000",
    "number": "1669732350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 NORTH 4TH STREET",
            "city": "COEUR D'ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-758-0568",
            "fax_number": "208-765-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 NORTH 4TH STREET",
            "city": "COEUR D'ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-758-0568",
            "fax_number": "208-765-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE HOLISTIC HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "208-758-0568",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DC, CAC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-932",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "ID",
            "license": "ACU-148",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT00001257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake City Medical Investors, LLC (Life Care Center of Coeur D'Alene)
• Lake City Physical Therapy P a
• Lake City Shoe Repair
• Lake City Surgeons PLLC
• Lakeside Eyecare
• Lakeside Pediatric & Adolescent Medicine, PLLC
• Lakeview Dental
• Lakewood Physical Therapy LLC
• Jared Lambert
• Tom Lamphier

• Naturopath in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Naturopath in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.