Lakeside Med, LLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

LAKESIDE MED, LLC

Practice address

723 N Market St # 207
Frederick, MD 21701-5232

Phone

(301) 660-8875

Fax

(443) 222-8164

NPI assigned

Oct 23, 2023

Organization subpart

Yes

Parent organization

LAKESIDE MED, LLCAs reported in NPPES

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

Authorized official

Name

Douglas H. Brown, EDD(C)NPI 1467638502

Title

Managing Partner

Phone

(301) 660-8875

Specialties & licenses 1

Addresses

Other names 1

• ComingOut Health Doing business as

Part of

Lakeside Med LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Lakeside Med, LLC

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1073142147
  NPPES parent name

Practitioners 1

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

• Douglas H. Brown, PA-C

  • Physician Assistant
  • Frederick, MD
  • NPI 1467638502

  Medical

  NPD Authorized official

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1891567053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 N MARKET ST # 207",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015232",
            "telephone_number": "301-660-8875",
            "fax_number": "443-222-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 N MARKET ST # 207",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015232",
            "telephone_number": "301-660-8875",
            "fax_number": "443-222-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MED, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKESIDE MED, LLC",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "301-660-8875",
        "authorized_official_credential": "EDD(C)"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ComingOut Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laibon Health LLC
• Monica Ann Laird, OTRL
• Lake Linganore Psychiatry, PLLC
• Sandra L Lake, L.C.S.W.-C.
• Lakeside Med, LLC
• Matthew Lalli
• Hoa T K Lam, DDS
• Briscel Grace Lamas, RBT - 21- 174603
• Marilyn Lamb, LPN
• Patricia F. Lamb, LCSW-C

• Medical Physician Assistant in Frederick, MD
• Providers in Frederick, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.