Active NPI
Adam W Lake, MED, ATC, CSCS
- Athletic Trainer
- Solon, OH
National Provider Identifier
1679534242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-002230
- Practice address
- 29800 Bainbridge Rd
Cleveland Clinic Sports Health
Solon, OH 44139-2202 - Phone
- (440) 914-8603
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-002230 | OH | Primary |
Addresses
Primary practice location
29800 Bainbridge Rd
Cleveland Clinic Sports Health
Solon, OH 44139-2202
Mailing address
281 Beeler Dr
Berea, OH 44017-1438
Phone (440) 554-8641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-002230 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679534242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "281 BEELER DR",
"city": "BEREA",
"state": "OH",
"postal_code": "440171438",
"telephone_number": "440-554-8641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29800 BAINBRIDGE RD",
"address_2": "CLEVELAND CLINIC SPORTS HEALTH",
"city": "SOLON",
"state": "OH",
"postal_code": "441392202",
"telephone_number": "440-914-8603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "ADAM",
"middle_name": "W",
"credential": "MED, ATC, CSCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT-002230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Solon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.