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LAKE REGIONAL CLINIC-ELDON
NPI 1053427492
Clinic/Center - Rural Health in Eldon, MO

Active since August 21, 2006CLIA 26D0445864 · Waiver
304A E 4TH ST, ELDON, MO 65026(573) 392-5654(573) 392-5692 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Lake Regional Clinic-eldon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE REGIONAL CLINIC-ELDON (NPI 1053427492) is a healthcare organization registered as a rural health in Eldon, Missouri and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through April 23, 2027 and lists Kevin Mcroberts, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053427492
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameLAKE REGIONAL HEALTH SYSTEM
Location Address304A E 4TH STEldon, MO 65026-1808
Mailing AddressPo Box 801661Kansas City, MO 64180-1500 · (573) 348-8000
Phone(573) 392-5654
Fax(573) 392-5692
Organization SubpartNo
Authorized OfficialKevin McrobertsCeo · (573) 348-8756
Enumeration DateAugust 21, 2006
Last NPPES UpdateOctober 12, 2023
NPPES CertifiedOctober 12, 2023
✔ NPI 1053427492 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
304A E 4TH ST, Eldon, MO 65026
Open in Google Maps ↗

Other Names 1

Doing Business AsLake Regional Clinic-eldon

Other Identifiers 1

Medicaid592540009MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0445864

Lake Regional Health System - Eldon · Eldon, MO
Active · expires Apr 23, 2027
CLIA Number26D0445864
Laboratory TypeRural Health Clinic
Certificate Effective DateApril 24, 2025
Certificate Expiration DateApril 23, 2027
Laboratory DirectorJoan M. Hanff
Laboratory Phone(573) 392-5654
Laboratory LocationLake Regional Health System - Eldon416 S Maple St, Eldon, MO 65026
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 13

Medicare supplier enrollment and the product categories Lake Regional Pharmacy - Cmc carries, from the Medicare DMEPOS supplier directory.

Lake Regional Pharmacy - Cmc

DMEPOS supplier · Camdenton, MOOperated by Lake Regional Medical Management Inc
⋮

Does not accept Medicare assignment

Lake Regional Pharmacy - Cmc has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20417855
Medicare Participant SinceJanuary 1, 2020
Supplier Location1930 C North Business Rte 5Camdenton, MO 65020
Phone(573) 346-2300
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Blood Glucose Monitors/Supplies (Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. HENRY KEILER BLUHM JR. PA-C
Physician Assistant (Medical)
304A E 4TH ST
ELDON, MO 65026
Miller County (573) 557-2400
KRISTEN SHAVAUGHN STAMPEHL NP-C
Nurse Practitioner (Family)
304A E 4TH ST
ELDON, MO 65026
Miller County (573) 392-5654
MICHAEL JAMES LEWIS FNP-BC
Nurse Practitioner (Family)
304A E 4TH ST
ELDON, MO 65026
Miller County (573) 552-5700
CHRISTINE ANN LIVEK M.D.
Family Medicine
304A E 4TH ST
ELDON, MO 65026
Miller County (573) 557-2400
EVGENIYA BANINA M.D.
Internal Medicine
304A E 4TH ST
ELDON, MO 65026
Miller County (573) 392-5654
DR. PAUL BERNABE M.D.
Family Medicine
304A E 4TH ST
ELDON, MO 65026
Miller County (573) 392-5654
KAYDIE ANN DIAL FNP
Nurse Practitioner (Family)
304A E 4TH ST
ELDON, MO 65026
Miller County (573) 392-5654
MRS. LAUREN NICOLE FREEZE FNP-C
Nurse Practitioner (Family)
304A E 4TH ST
ELDON, MO 65026
Miller County (573) 392-5654

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Regional Health System's NPI number?

The NPI number for Lake Regional Health System is 1053427492. It was assigned to this organization in the NPPES registry on August 21, 2006. The provider is doing business as Lake Regional Clinic-Eldon.

Where is Lake Regional Health System located?

Lake Regional Health System is located at 304A E 4th St, Eldon, MO 65026. The listed phone number is (573) 392-5654.

What is Lake Regional Health System's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Lake Regional Health System accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Lake Regional Pharmacy - Cmc does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Lake Regional Health System hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0445864) is associated with this NPI, valid through April 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Regional Health System accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 3 other insurers list Lake Regional Health System as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Regional Health System was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.