Lake Medical Center PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP1951902 Issued in FL

Legal business name

LAKE MEDICAL CENTER PLLC

Practice address

425 SE 2ND St
Belle Glade, FL 33430-3511

Phone

(561) 992-0508

Fax

(561) 992-0510

NPI assigned

Jan 23, 2014

Organization subpart

No

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

Authorized official

Name

Susan McMillan, ARNPNPI 1710060421

Title

Nurse Practioneer

Phone

(561) 992-0508

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan S McMillan, ARNP

  • Family Nurse Practitioner
  • Belle Glade, FL
  • NPI 1710060421
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397347200000",
    "number": "1699198903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 SE 2ND ST",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334303511",
            "telephone_number": "561-992-0508",
            "fax_number": "561-992-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 SE 2ND ST",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334303511",
            "telephone_number": "561-992-0508",
            "fax_number": "561-992-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-04-13",
        "status": "A",
        "authorized_official_last_name": "MCMILLAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "NURSE PRACTIONEER",
        "authorized_official_telephone_number": "561-992-0508",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP1951902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidz World Therapy Services LLC
• Erica Knight
• Stan K Kotei, RPH
• Hina Anjom Laeeq, PA
• Lake Express Pharmacy Inc
• Lake Pharmacy Inc
• Lakeshore Anesthesia, Inc.
• Lakeside Medical Center
• Mallory Lazell, DPT
• Wodwentzky Lefranc, MD

• Family Nurse Practitioner in Belle Glade, FL
• Providers in Belle Glade, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.