NPIMap

Organization Active NPI

Lake County Medical Clinic, P.C.

  • Family Medicine Physician
  • Lakeview, OR
National Provider Identifier
1922085604
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAKE COUNTY MEDICAL CLINIC, P.C.
Practice address
624 S J St
Lakeview, OR 97630-1680
Phone
(541) 947-3366
Fax
(541) 947-4404
NPI assigned
Dec 23, 2005
Last updated
Jul 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Authorized official

Name
Mrs. Sheena M Felder
Title
Office Manager
Phone
(541) 947-3366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OR Primary

Addresses

Primary practice location

624 S J St
Lakeview, OR 97630-1680

Mailing address

624 S J St
Lakeview, OR 97630-1680
Phone (541) 947-3366

Other identifiers 1

IdentifierTypeStateIssuer
246694MedicaidOR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1922085604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 S J ST",
            "city": "LAKEVIEW",
            "state": "OR",
            "postal_code": "976301680",
            "telephone_number": "541-947-3366",
            "fax_number": "541-947-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 S J ST",
            "city": "LAKEVIEW",
            "state": "OR",
            "postal_code": "976301680",
            "telephone_number": "541-947-3366",
            "fax_number": "541-947-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY MEDICAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "FELDER",
        "authorized_official_first_name": "SHEENA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-947-3366",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246694",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeview, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.