LAKESHORE MEDICAL CARE CENTER, INC
NPI 1124195573
Preferred Provider Organization in Jacksonville, FL
NPI Status: Active since November 29, 2006
Contact Information
4616 SAN JUAN AVE
JACKSONVILLE, FL
ZIP 32210
Phone: (904) 384-5385
Fax: (904) 388-5838
- Organization
- Preferred Provider Organization
About LAKESHORE MEDICAL CARE CENTER, INC
This page provides the complete NPI Profile along with additional information for Lakeshore Medical Care Center, Inc, a provider established in Jacksonville, Florida operating as a Preferred Provider Organization. The healthcare provider is registered in the NPI registry with number 1124195573 assigned on November 2006. The practitioner's primary taxonomy code is 305R00000X with license number 0042816 (FL). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Miss Tracy Teagle (Office Manager)
- NPI
- 1124195573
- Provider Name
- LAKESHORE MEDICAL CARE CENTER, INC
- Entity Type
- Organization
- Location Address
- 4616 SAN JUAN AVE JACKSONVILLE, FL 32210
- Location Phone
- (904) 384-5385
- Location Fax
- (904) 388-5838
- Mailing Address
- 4616 SAN JUAN AVE JACKSONVILLE, FL 32210
- Mailing Phone
- (904) 384-5385
- Mailing Fax
- (904) 388-5838
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-29-2006
- Last Update Date
- 12-27-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Preferred Provider Organization
- Taxonomy Code
- 305R00000X
- Type
- Managed Care Organizations
- License No.
- 0042816
- License State
- FL
- Taxonomy Description
- A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 305R00000X | Managed Care Organizations | Preferred Provider Organization | ME0018387 (FL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 26456 | MEDICARE ID-TYPE UNSPECIFIED (04) | FL | |
| 16859W | MEDICARE ID-TYPE UNSPECIFIED (04) | FL |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124195573, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124195573, enumerated as an "organization" on November 29, 2006.
The provider is located at 4616 SAN JUAN AVE JACKSONVILLE, FL 32210 and the phone number is (904) 384-5385.
Preferred Provider Organization with taxonomy code 305R00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
