Lake Obstetrics and Gynecology, Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

LAKE OBSTETRICS AND GYNECOLOGY, INC

Practice address

8300 Tyler Blvd Ste 300
Mentor, OH 44060-4251

Phone

(440) 557-7100

NPI assigned

Apr 6, 2006

Last updated

Aug 7, 2025By 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

Susanna Bowman

Title

Office Manager

Phone

(440) 357-7100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Tax ID family

Lake Obstetrics and Gynecology Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Lake Obstetrics and Gynecology, Inc

  • Obstetrics & Gynecology Physician
  • Painesville, OH
  • NPI 1730145020
  NPD tax ID

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alyssa Nicole Bledsoe, APRN-CNM

  • Advanced Practice Midwife
  • Mentor, OH
  • NPI 1073322277
  Medicare reassignment Care Compare group NPD
• Rosemary Brownlee, MD

  • Obstetrics & Gynecology Physician
  • Mentor, OH
  • NPI 1700842812
  Medicare reassignment Care Compare group NPD
• Kristen Eichorn, MD

  • Obstetrics & Gynecology Physician
  • Mentor, OH
  • NPI 1750709150
  Medicare reassignment Care Compare group NPD
• Abigail Marie Tucker, MD

  • Obstetrics & Gynecology Physician
  • Mentor, OH
  • NPI 1043229503
  Medicare reassignment Care Compare group NPD
• Jennifer A Velotta, M.D.

  • Obstetrics & Gynecology Physician
  • Mentor, OH
  • NPI 1003000423
  Medicare reassignment Care Compare group NPD
• Rachel Weaver, M.D

  • Obstetrics & Gynecology Physician
  • Mentor, OH
  • NPI 1073923967
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1811950447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 TYLER BLVD STE 300",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604251",
            "telephone_number": "440-357-7100",
            "fax_number": "440-357-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 TYLER BLVD STE 300",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604251",
            "telephone_number": "440-557-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Mentor Ave",
            "address_purpose": "LOCATION",
            "city": "Mentor",
            "state": "OH",
            "postal_code": "440608713",
            "country_code": "US",
            "telephone_number": "440-357-7100",
            "fax_number": "440-357-8132",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7580 Auburn Rd Ste 313",
            "address_purpose": "LOCATION",
            "city": "Concord Twp",
            "state": "OH",
            "postal_code": "440779618",
            "country_code": "US",
            "telephone_number": "440-352-0688",
            "fax_number": "440-352-3724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6270 N Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "OH",
            "postal_code": "440572567",
            "country_code": "US",
            "telephone_number": "440-357-7100",
            "fax_number": "440-357-8132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE OBSTETRICS AND GYNECOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "440-357-7100"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0890175",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Hospital System, Inc. (Lake Health Home Care Services)
• Lake Hospital System, Inc. (LHPG Tyler Sports Medicine)
• Lake Hospital System, Inc. (Lake Health Physician Group Ob/Gyn)
• Lake Hospital System, Inc. (Lake County Family Practice)
• Lake Hospital System, Inc. (PrimeHealth Internal Medicine Mentor)
• Lake Orthopaedic Associates, Inc.
• Lake-Geauga Recovery Centers, Inc
• Lake-Geauga Recovery Centers, Inc.
• Lakireddy Dental LLC
• Christine Lalich, LISW-S

• Obstetrics & Gynecology Physician in Mentor, OH
• Providers in Mentor, OH by specialty
• Obstetrics & Gynecology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.