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INTEGRATIVE MEDICINE LAKE COUNTRY, LLC
NPI 1235945346
Clinic/Center - Medical Specialty in Hartland, WI

Active since December 04, 2024
138 NORTH AVE STE 4, HARTLAND, WI 53029(262) 256-3020 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Integrative Medicine Lake Country, Llc NPPES

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

INTEGRATIVE MEDICINE LAKE COUNTRY, LLC (NPI 1235945346) is a healthcare organization registered as a medical specialty in Hartland, Wisconsin and active in the NPI registry since December 2024. The organization lists Jamie Kaminski, Owner, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1235945346
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameINTEGRATIVE MEDICINE LAKE COUNTRY, LLC
Location Address138 NORTH AVE STE 4Hartland, WI 53029-1725
Mailing Address138 North Ave Ste 4Hartland, WI 53029-1725 · (262) 256-3020
Phone(262) 256-3020
Organization SubpartNo
Authorized OfficialJamie KaminskiOwner, Nurse Practitioner · (262) 256-3020
Enumeration DateDecember 4, 2024
NPPES CertifiedDecember 4, 2024
✔ NPI 1235945346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
138 NORTH AVE STE 4, Hartland, WI 53029
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Integrative Medicine Lake Country, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Integrative Medicine Lake Country, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jamie Kaminski
Nurse Practitioner
NPI 1568074359
6609 W GREENFIELD AVE
West Allis, WI 53214
(414) 257-8577
✔ PECOS19 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Integrative Medicine Lake Country, LLC's NPI number?

The NPI number for Integrative Medicine Lake Country, LLC is 1235945346. It was assigned to this organization in the NPPES registry on December 4, 2024.

Where is Integrative Medicine Lake Country, LLC located?

Integrative Medicine Lake Country, LLC is located at 138 North Ave Ste 4, Hartland, WI 53029. The listed phone number is (262) 256-3020.

What is Integrative Medicine Lake Country, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is Integrative Medicine Lake Country, LLC enrolled in Medicare?

Yes. Integrative Medicine Lake Country, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Integrative Medicine Lake Country, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Integrative Medicine Lake Country, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Integrative Medicine Lake Country, LLC was last updated on December 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.