Lakeside Family Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

F0514016 Issued in GA

Legal business name

LAKESIDE FAMILY MEDICINE

Practice address

104 Carrington Park Dr Ste B
Gainesville, GA 30504-6603

Phone

(770) 899-3773

NPI assigned

May 4, 2017

Organization subpart

No

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

Authorized official

Name

Foroogh Narmani-Mohammadi, DNP, FNP-CNPI 1447659347

Title

Family Nurse Practitioner

Phone

(770) 899-3773

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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.

• Foroogh Narmani-Mohammadi, DNP, FNP-C

  • Family Nurse Practitioner
  • Gainesville, GA
  • NPI 1447659347
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493856000000",
    "number": "1720514029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CARRINGTON PARK DR STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305046603",
            "telephone_number": "770-899-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CARRINGTON PARK DR STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305046603",
            "telephone_number": "770-899-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-04",
        "last_updated": "2017-05-04",
        "status": "A",
        "authorized_official_last_name": "NARMANI-MOHAMMADI",
        "authorized_official_first_name": "FOROOGH",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "770-899-3773",
        "authorized_official_credential": "DNP, FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "F0514016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew N Lake, MD
• Lisa Ramsland Lake, OTR/L
• Lakeshore Chiropratic
• Lakeshore Mall Dental Group
• Lakeshore Tubal Reversal Center
• Lakeside Integrated Group, LLC
• Lakeside OB/GYN and Pelvic Surgery, LLC
• Sanjay M Lall, M.D.
• Christine D Lallos, MD
• Hamilton Vo Lam, M.D., MPH

• Primary Care Clinic/Center in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.