Lake Regional Health System

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKE REGIONAL HEALTH SYSTEM

Practice address

54 Hospital Dr
Osage Beach, MO 65065-3050

Phone

(573) 348-8000

NPI assigned

Mar 5, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Kevin McRoberts

Title

Ceo

Phone

(573) 348-8756

Specialties & licenses 9

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lake Regional Health System

  • Emergency Medical Services (Emergency Medicine) Physician
  • Osage Beach, MO
  • NPI 1053581454

  O20070511000147

  Same enrollment
• Lake Regional Health System

  • Rural Acute Care Hospital
  • Osage Beach, MO
  • NPI 1386619450

  O20070511000147

  Same enrollment

Locations

Practitioners 142

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

• Kayla Allison, FNP

  • Family Nurse Practitioner
  • Eldon, MO
  • NPI 1952296725
  NPD
• Julia G Ansari, M.D.

  • Interventional Cardiology Physician
  • Osage Beach, MO
  • NPI 1780846881
  NPD
• Whitney Nicole Arnold, PA

  • Physician Assistant
  • Lebanon, MO
  • NPI 1972043644
  NPD
• Evgeniya Banina, M.D.

  • Internal Medicine Physician
  • Eldon, MO
  • NPI 1205280427
  NPD
• Randall C Barnes, D.O.

  • Family Medicine Physician
  • Osage Beach, MO
  • NPI 1275577926
  NPD
• David N Bergthold, MSN-ACNP

  • Acute Care Nurse Practitioner
  • Osage Beach, MO
  • NPI 1336331065
  NPD
• Andrew Joseph Blaes, NP

  • Nurse Practitioner
  • Joplin, MO
  • NPI 1659763993
  NPD
• Jason Wells Blair, D.O.

  • Hospitalist Physician
  • Joplin, MO
  • NPI 1588951750

  Internal Medicine

  NPD
• John Carlyn Brand, D.O.

  • Family Medicine Physician
  • Osage Beach, MO
  • NPI 1144451774
  NPD
• Joshua Palmer Brickner, D.O.

  • Internal Medicine Physician
  • Osage Beach, MO
  • NPI 1598994493
  NPD
• Brandon C.W. Brown, MD

  • Family Medicine Physician
  • Gravois Mills, MO
  • NPI 1225398019
  NPD
• Erin Renee Burnette, NP

  • Family Nurse Practitioner
  • Fort Leonard Wood, MO
  • NPI 1700193174
  NPD

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1962828616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801661",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801661",
            "telephone_number": "573-348-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-348-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGIONAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-05",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "MCROBERTS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-348-8756",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010671600",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Regional Health System
• Lake Regional Health System
• Lake Regional Health System
• Lake Regional Health System
• Lake Regional Health System
• Lake Regional Imaging Partners, LLC
• Lake Regional Medical Management, Inc.
• Mark S. Lake, D.D.S.
• Lakeside Obstetrics & Gynecology LLC
• Carlee Lamb

• Internal Medicine Physician in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.