LAKESIDE OAKS CARE CENTER
NPI 1174892947
Skilled Nursing Facility in Dunedin, FL

NPI Status: Active since December 22, 2011

Contact Information

1061 VIRGINIA ST
DUNEDIN, FL
ZIP 34698
Phone: (727) 733-4189
Fax: (727) 734-7651

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Skilled Nursing Facility
Accepts Insurance
CLIA Number: 10D0026211
CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
CLIA Exp. Date: 08-31-2026

About LAKESIDE OAKS CARE CENTER

This page provides the complete NPI Profile along with additional information for Lakeside Oaks Care Center, a provider established in Dunedin, Florida operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1174892947 assigned on December 2011. The practitioner's primary taxonomy code is 314000000X with license number SNF15100962 (FL). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Lakeside Oaks Care Center. The authorized official of this NPI record is Kenneth Ussery (Vp)

NPI: 1174892947
Provider Legal Name: 1061 VIRGINIA STREET OPERATIONS LLC
Other Organization Name: LAKESIDE OAKS CARE CENTER
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 1061 VIRGINIA ST DUNEDIN, FL 34698
Location Phone: (727) 733-4189
Location Fax: (727) 734-7651
Mailing Address: 1061 VIRGINIA ST DUNEDIN, FL 34698
Mailing Phone: (727) 733-4189
Mailing Fax: (727) 734-7651
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 12-22-2011
Last Update Date: 11-27-2023
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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: Skilled Nursing Facility
Taxonomy Code: 314000000X
Type: Nursing & Custodial Care Facilities
License No.: SNF15100962
License State: FL
Taxonomy Description: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Ambetter from Superior HealthPlan

Clear VALUE Silver - HMO
Complete VALUE Gold - HMO
Focused VALUE Silver - HMO
Focused VALUE Silver + Vision + Adult Dental - HMO
Standard Gold VALUE - HMO
Standard Silver VALUE - HMO
Standard Silver VALUE + Vision + Adult Dental - HMO

Ambetter Health

Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Complete VALUE Gold - HMO
Complete VALUE Silver - HMO
Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - HMO
Elite Silver - HMO
Elite Silver + Vision + Adult Dental - HMO
Elite VALUE Bronze - HMO
Enhanced Diabetes Care Silver with $0 Drug Options - HMO
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Everyday Gold - HMO
Everyday Gold + Vision + Adult Dental - HMO
Focused Silver - HMO
Focused Silver + Vision + Adult Dental - HMO
Focused VALUE Silver - HMO
Standard Expanded Bronze - HMO
Standard Expanded Bronze + Vision + Adult Dental - HMO

Ambetter of Alabama

Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Elite Gold - EPO
Elite Gold + Vision + Adult Dental - EPO
Elite Silver - EPO
Elite Silver + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Focused Silver - EPO
Focused Silver + Vision + Adult Dental - EPO
Standard Expanded Bronze - EPO
Standard Expanded Bronze + Vision + Adult Dental - EPO
Standard Gold - EPO
Standard Gold + Vision + Adult Dental - EPO
Standard Silver - EPO

Florida Blue (BlueCross BlueShield FL)

BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
BlueSelect Bronze 1449 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - EPO
BlueSelect Bronze 2139 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - EPO
BlueSelect Bronze 2139E ($0 Virtual PCP Visits / $50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
BlueSelect Bronze 2139V ($0 Virtual PCP Visits / $50 PCP Visits / Adult Vision / Rewards) - EPO
BlueSelect Bronze 2342S ($50 PCP Visits / Multilingual Available / Rewards) - EPO

Florida Blue HMO (a BlueCross BlueShield FL company)

BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) - POS
BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) - POS
BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) - POS
BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - POS
BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) - POS

Health First Commercial Plans, Inc.

Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
Bronze 1826 + Adult Dental + Adult Vision ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access) - HMO
Bronze Savings 1820 + Adult Dental + Adult Vision (Primary Care Copay Visits 1-5, Open Access) - HMO
Bronze Standard 1828 - HMO
Bronze Value 1814 (High Value Network Savings, Open Access) - HMO
Bronze Value 1814 + Adult Dental + Adult Vision (High Value Network Savings, Open Access) - HMO
Catastrophic 1746 (Primary Care Copay Visits 1-3, Open Access) - HMO
Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
Gold 1742 + Adult Dental + Adult Vision (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
Gold Savings 1825 ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
Gold Savings 1825 + Adult Dental + Adult Vision ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
Gold Standard 1833 - HMO
Gold Value 1819 ($1,300 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
Gold Value 1819 + Adult Dental + Adult Vision ($1,300 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
Silver 1664 (Primary Care & Specialist Copays, Open Access) - HMO
Silver 1664 + Adult Dental + Adult Vision (Primary Care & Specialist Copays, Open Access) - HMO
Silver Savings 1821 (Primary Care Copay, Open Access) - HMO
Silver Savings 1821 + Adult Dental + Adult Vision (Primary Care Copay, Open Access) - HMO
Silver Standard 1829 - HMO

Molina Healthcare

Bronze 4 - HMO
Bronze 8 - HMO
Gold 1 - HMO
Gold 1 with Adult Vision Services - HMO
Gold 8 - HMO
Silver 1 - HMO
Silver 1 with Adult Vision Services - HMO
Silver 12 with First 4 Primary Care Visits Free - HMO
Silver 8 - HMO
Silver 9 - HMO

Oscar Insurance Company of Florida

Bronze Classic 4700 - EPO
Bronze Classic Standard - EPO
Bronze Elite + PCP Saver Plus - EPO
Gold Classic Standard - EPO
Gold Elite - EPO
Gold Elite Saver Plus - EPO
Secure - EPO
Silver Classic Standard - EPO
Silver Elite - EPO
Silver Simple Chronic Care CKM - EPO
Silver Simple Diabetes - EPO
Silver Simple PCP Saver - EPO

Wellpoint

Wellpoint Essential Bronze 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Wellpoint Essential Bronze 5500 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
Wellpoint Essential Catastrophic 9200 (+ Incentives) - HMO
Wellpoint Essential Gold 1400 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Wellpoint Essential Gold 800 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Wellpoint Essential Silver 5000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: KENNETH USSERY
Authorized Official Title: VP
Authorized Official Phone: (407) 571-1550

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
006114000	MEDICAID (05)	FL

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 10D0026211
Facility Type: Skilled Nursing Facility/Nursing Facility
Certificate Effective Date: September 01, 2024
Certificate Expiration Date: August 31, 2026
Laboratory Director: PAULINE INTAL-CARR
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Lakeside Oaks Care Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	1	7	4	8	9	2	9	4	7
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	1	14	4	16	9	4	9	8
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 4 + 4 + 1 + 6 + 9 + 4 + 9 + 8 + 24 = 73
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 73 = 7									7

The NPI number 1174892947 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.