LAKE REGIONAL CLINIC-LEBANON
NPI 1386311223
Clinic/Center - Rural Health in Lebanon, MO
About Lake Regional Clinic-lebanon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE REGIONAL CLINIC-LEBANON (NPI 1386311223) is a healthcare organization registered as a rural health in Lebanon, Missouri and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through April 30, 2027 and lists Kevin Mcroberts, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and revalidation status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lake Regional Clinic-lebanon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
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 26D2153734
Lake Regional System - Lebanon · Lebanon, MOOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 1386311223. It was assigned to this organization in the NPPES registry on August 27, 2021. The provider is doing business as Lake Regional Clinic-Lebanon.
Where is Lake Regional Health System located?
Lake Regional Health System is located at 755 Cowan Drive, Lebanon, MO 65536. The listed phone number is (417) 532-2805.
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.
Is Lake Regional Health System enrolled in Medicare?
Yes. Lake Regional Health System is registered in the Medicare PECOS enrollment system.
When is Lake Regional Health System's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Missouri, Rural Health Clinic) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
Does Lake Regional Health System hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 26D2153734) is associated with this NPI, valid through April 30, 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 Sunflower Health Plan and Ambetter of Oklahoma and 1 other insurer 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 3 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.
# Lake Regional Clinic-Lebanon · NPI 1386311223
Rural Health organization in Lebanon, Missouri. Organization record, active in the CMS NPPES registry since August 27, 2021.
## Identity
- **NPI:** 1386311223 (Entity type: Organization)
- **Enumerated:** August 27, 2021
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Legal business name:** Lake Regional Health System
- **Organization subpart:** No
- **Authorized official:** Kevin Mcroberts, CEO
## Practice location
- **Address:** 755 COWAN DRIVE, Lebanon, MO 65536
- **Phone:** (417) 532-2805 · **Fax:** (417) 532-2848
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Part A, Missouri, Rural Health Clinic) · CMS Revalidation Due Date List, October 2026 release
## Record status
- **NPPES last updated:** October 12, 2023
- **Other identifiers:** Medicaid 590107490 (MO)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1386311223) · Data from the CMS NPPES public registry.