NPIMap

Organization Active NPI

Lakeside Health System

  • Critical Access Hospital
  • Brockport, NY
National Provider Identifier
1679811327
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
F430661-1 Issued in NY
Legal business name
LAKESIDE HEALTH SYSTEM
Practice address
156 West Ave
Brockport, NY 14420-1229
Phone
(585) 395-6095
NPI assigned
Jan 30, 2013
Last updated
Jan 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Authorized official

Name
Mrs. Florence Ndikum Ndongwa, NPNPI 1285075663
Title
Nurse Practitioner
Phone
(585) 957-5050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X F430661-1 NY Primary

Addresses

Primary practice location

156 West Ave
Brockport, NY 14420-1229

Mailing address

128 Country Wood LNDG
Rochester, NY 14626-4408
Phone (585) 957-5050

National Provider Directory

National Provider Directory
Tax ID family
Lakeside Memorial Hosp Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1679811327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 COUNTRY WOOD LNDG",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264408",
            "telephone_number": "585-957-5050"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "NDONGWA",
        "authorized_official_first_name": "FLORENCE",
        "authorized_official_middle_name": "NDIKUM",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "585-957-5050",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NY",
            "license": "F430661-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.