LAKESIDE CLINIC LLC – NPI #1477657823
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

LAKESIDE CLINIC LLC is a provider located in GUNTERSVILLE, AL. NPPES has assigned the NPI number 1477657823 to LAKESIDE CLINIC LLC on September 07, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 2 years ago on Apr 24, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKESIDE CLINIC LLC below.

NPI Profile for
LAKESIDE CLINIC LLC

NPI Number
1477657823
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LAKESIDE CLINIC LLC
Primary location
2337 HOMER CLAYTON DRIVE
GUNTERSVILLE, AL 35976
Phone: (256) 582-5131 Fax: (256) 582-1100
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
CAROLYN MASON
ADMINISTRATOR
Phone: (256) 582-5131
Updated
Certification Date
Apr 23, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for LAKESIDE CLINIC LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
otherBOGGESS AL LIC NUMBER9801
otherBOGGESS PROVIDER NUMBER051550006
otherFOLEY AL LIC NUMBER25574
otherFOLEY PROVIDER NUMBER051518706
otherLARSON AL LIC NUMBER10014
otherLARSON PROVIDER NUMBER051550004
otherNIXON AL LIC NUMBER22839
otherNIXON PROVIDER NUMBER051502549
otherREED-JOHNSON AL LIC NUMB23185
otherREED-JOHNSON PROVIDER NUM051509352
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.