Madison Health Investors, LC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF16360961 Issued in FL

Legal business name

MADISON HEALTH INVESTORS, LC

Doing business as

Lake Park of Madison

Practice address

259 SW Captain Brown Rd
Madison, FL 32340-4316

Phone

(850) 973-8277

Fax

(850) 973-4006

NPI assigned

Sep 22, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Charles E. Trefzger Jr.

Title

Managing Member

Phone

(828) 322-5535

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lake Park of Madison Doing business as

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1962498105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 SW CAPTAIN BROWN RD",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323404316",
            "telephone_number": "850-973-8277",
            "fax_number": "850-973-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 SW CAPTAIN BROWN RD",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323404316",
            "telephone_number": "850-973-8277",
            "fax_number": "850-973-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON HEALTH INVESTORS, LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "TREFZGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "828-322-5535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF16360961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE FACILITY MDS ID NUM",
            "identifier": "24003",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021192300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Park of Madison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison County Hospital Health Systems, Inc. (Madison County Memorial Hospital)
• Madison County Hospital Health Systems, Inc. (Madison County Memorial Hospital)
• Madison County Hospital Health Systems, Inc.
• Madison County Hospital Health Systems, Inc. (Madison County Memorial Hospital)
• Madison Dental Associates
• Madison Memorial Healthcare Clinic (Madison Co Hospital Health Sys., Inc)
• Madison Osteopathic Medicine
• Madison Therapy & Wellness PLLC
• Tamara Maitlen
• James Martin

• Skilled Nursing Facility in Madison, FL
• Providers in Madison, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.