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LAKESIDE FAMILY MEDICINE ANDOVER
NPI 1235538828
Non-Pharmacy Dispensing Site in Andover, OH

Active since August 19, 2014CLIA 36D0333569 · Waiver
149 E MAIN ST, ANDOVER, OH 44003(440) 293-5555 Get Directions Write a Review

NPPES record last updated: August 19, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lakeside Family Medicine Andover NPPES

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

LAKESIDE FAMILY MEDICINE ANDOVER (NPI 1235538828) is a healthcare organization registered as a non-pharmacy dispensing site in Andover, Ohio and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through March 12, 2027 and lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1235538828
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameUPMC COMMUNITY MEDCINE INC
Location Address149 E MAIN STAndover, OH 44003-9479
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(440) 293-5555
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateAugust 19, 2014
✔ NPI 1235538828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in OH · 34.004448
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
149 E MAIN ST, Andover, OH 44003
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Other Names 1

Doing Business AsLakeside Family Medicine Andover

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.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 36D0333569

Lakeside Family Medicine - Upmc · Greenville, PA
Active · expires Mar 12, 2027
CLIA Number36D0333569
Laboratory TypePhysician Office
Certificate Effective DateMarch 13, 2025
Certificate Expiration DateMarch 12, 2027
Laboratory DirectorDr. Mark L. Stabile Jr
Laboratory Phone(440) 293-5555
Laboratory LocationLakeside Family Medicine - Upmc90 Shenango Street Suite #5, Greenville, PA 16125
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

ANCHOR OF HOPE CENTER
Case Management
149 E MAIN ST
ANDOVER, OH 44003
Ashtabula County (877) 248-5327
MARK L STABILE JR. D.O.
Family Medicine
149 E MAIN ST, BOX 1117
ANDOVER, OH 44003
Ashtabula County (440) 293-5555
SAMUEL J DAISLEY D.O.
Family Medicine
149 E MAIN ST, BOX 1117
ANDOVER, OH 44003
Ashtabula County (440) 293-5555
MRS. MARY THERESA JAMES CNP
Family Medicine
149 E MAIN ST
ANDOVER, OH 44003
Ashtabula County (440) 293-5555

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 Upmc Community Medcine Inc's NPI number?

The NPI number for Upmc Community Medcine Inc is 1235538828. It was assigned to this organization in the NPPES registry on August 19, 2014. The provider is doing business as Lakeside Family Medicine Andover.

Where is Upmc Community Medcine Inc located?

Upmc Community Medcine Inc is located at 149 E Main St, Andover, OH 44003. The listed phone number is (440) 293-5555.

What is Upmc Community Medcine Inc's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Upmc Community Medcine Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0333569) is associated with this NPI, valid through March 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Upmc Community Medcine Inc accept?

Health plans from Sanford Health Plan list Upmc Community Medcine Inc 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 Upmc Community Medcine Inc was last updated on August 19, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.