Jennifer L Lake

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

4298 Great Egret Way
Middleburg, FL 32068-8760

Phone

(803) 318-2052

NPI assigned

Jun 7, 2020

Last updated

Jun 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Enhancing the Quality of Life, LLC

  • Case Manager/Care Coordinator
  • Middleburg, FL
  • NPI 1942829734
  NPD
• Etqol Nurse Care Agency LLC

  • Case Manager/Care Coordinator
  • Middleburg, FL
  • NPI 1992651673
  NPD (past)

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

{
    "created_epoch": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591488000000",
    "number": "1760006506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3342 NOKOMIS RD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320736620",
            "telephone_number": "904-608-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4298 GREAT EGRET WAY",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688760",
            "telephone_number": "803-318-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-07",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ashlee Klanderman, DMD
• Whitney Renee Kopernik
• Betty Anne Koski, LMHC LMFT
• Krew Enterprises Inc. (Mobility Outfitters Inc.)
• Kateland Krueger
• Jessica Joyce Lakey, LM
• Gerald Lane
• Amanda Larsh, PHARMD
• Amanda Maria Larson
• Brittany Lautzenheiser, LCSW

• Case Manager/Care Coordinator in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2020; 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.