Lakewood Place, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LAKEWOOD PLACE, LLC

Doing business as

Lakewood Place

Practice address

1125 Grove Street
Loudon, TN 37774

Phone

(865) 458-4123

Fax

(865) 458-0960

NPI assigned

Sep 11, 2023

Last updated

Sep 11, 2023By 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

Mr. Christina Landis Trentham

Title

Executive Yp of Operations & Clinic

Phone

(865) 293-6563

Specialties & licenses 1

Addresses

Other names 1

• Lakewood Place Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1720865165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 GROVE STREET",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "37774",
            "telephone_number": "865-458-4123",
            "fax_number": "865-458-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 GROVE STREET",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "37774",
            "telephone_number": "865-458-4123",
            "fax_number": "865-458-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "TRENTHAM",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "LANDIS",
        "authorized_official_title_or_position": "EXECUTIVE YP OF OPERATIONS & CLINIC",
        "authorized_official_telephone_number": "865-293-6563",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Loraine Kirkland
• Stacy Kizziah
• Milton N Kondiles, DPM
• Chris Kszos, DPT
• Tonya E Kukla, CRNA
• David W. Lambert, D.D.S.
• Irina Lavrik, MD
• James Wendell Leach, M.D.
• Candace Lindsey, NP
• Leslie Lindsey, PT

• Assisted Living Facility in Loudon, TN
• Providers in Loudon, TN by specialty
• Assisted Living Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.