Lakeside Women'S Center of Oklahoma City, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

LAKESIDE WOMEN'S CENTER OF OKLAHOMA CITY, LLC

Practice address

11200 N Portland Ave
Oklahoma City, OK 73120-5045

Phone

(405) 936-1500

Fax

(405) 418-0524

NPI assigned

Mar 10, 2011

Organization subpart

Yes

Parent organization

LAKESIDE WOMEN'S CENTER OF OKLAHOMA CITY, LLCAs reported in NPPES

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

Authorized official

Name

Darla McCallister

Title

Cfo

Phone

(405) 936-1554

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lakeside Physician Group Doing business as

Tax ID family

Lakeside Womens Hospital2 organizations share this tax ID, including this one

Part of

Lakeside Womens Hospital

Other organizations with this tax ID 1

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

• Lakeside Women'S Hospital, LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1639170699
  NPD tax ID

Locations

Practitioners 1

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

• Sarah Mashburn

  • Obstetrics & Gynecology Physician
  • Oklahoma City, OK
  • NPI 1841796299
  NPD (past)

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1811295108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8387",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158300",
            "telephone_number": "405-936-1577",
            "fax_number": "866-354-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731205045",
            "telephone_number": "405-936-1500",
            "fax_number": "405-418-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE WOMEN'S CENTER OF OKLAHOMA CITY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKESIDE WOMEN'S CENTER OF OKLAHOMA CITY, LLC",
        "enumeration_date": "2011-03-10",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "MCCALLISTER",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "405-936-1554"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000370199001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100745350C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lakepointe Pet, LLC
• Lakepointe Physical Therapy
• Lakeside Family Dentistry, PLLC
• Lakeside Oral Surgery PLLC
• Lakeside Pediatrics PC
• Lakeside Women'S Hospital, LLC
• Alexander Lakin
• Jacob Joseph Lalonde, DDS
• Anh Lam, DO
• David Wong Lam, MD

• Obstetrics & Gynecology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Obstetrics & Gynecology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.