Lake Shore Hma, LLC

Primary specialty

Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X

License

4268 Issued in FL

Legal business name

LAKE SHORE HMA, LLC

Doing business as

Shands Lake Shore Regional Medical Center

Practice address

368 NE Franklin St
Lake City, FL 32055-3088

Phone

(386) 292-8000

Fax

(386) 795-8369

NPI assigned

Nov 14, 2017

Organization subpart

Yes

Parent organization

LAKE SHORE HMA, LLCAs reported in NPPES

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

Authorized official

Name

Paula Lalor

Title

Director/ Delegated Official

Phone

(615) 925-4565

Specialties & licenses 1

Addresses

Other names 1

• Shands Lake Shore Regional Medical Center Doing business as

Part of

Lake Shore Hma LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Shands Teaching Hospital and Clinics Inc

  • Radiology Clinic/Center
  • Ocala, FL
  • NPI 1942031232

  Member Of

  NPD member

Locations

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.

• Lake Shore Hma, LLC

  • General Acute Care Hospital
  • Lake City, FL
  • NPI 1386743045
  NPPES parent name

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510617600000",
    "number": "1912410804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 NE FRANKLIN ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320553088",
            "telephone_number": "386-292-8000",
            "fax_number": "386-795-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 NE FRANKLIN ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320553088",
            "telephone_number": "386-292-8000",
            "fax_number": "386-795-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SHORE HMA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKE SHORE HMA, LLC",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "DIRECTOR/ DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "615-925-4565"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "FL",
            "license": "4268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shands Lake Shore Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lake City Vision PA
• Lake Citytherapeutic LLC
• Lake Shore Center for Aesthetics & Plastic Surgery PA
• Lake Shore Hma Medical Group LLC
• Lake Shore Hma, LLC
• Vasu Nagaraju Lakkimsetti, M.D.,
• Anthony R Lambert, PA-C
• Paula Lamon, ARNP
• Carol Landen
• Rickey Ellis Landon, M.D.

• Medicare Defined Swing Bed Hospital Unit in Lake City, FL
• Providers in Lake City, FL by specialty
• Medicare Defined Swing Bed Hospital Unit in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; 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.