LAKE EFFECT HEALTH
NPI 1780156984
Nurse Practitioner in Cleveland, OH

Active since December 28, 2018CLIA 36D2161020 · Waiver
3611 PROSPECT AVE E, CLEVELAND, OH 44115(440) 289-7584(216) 331-6751 Get Directions Write a Review

NPPES record last updated: September 16, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 16, 2024, Apr 21, 2022, Apr 6, 2022 and 1 more (4 updates tracked since 2018).

About Lake Effect Health NPPES

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

LAKE EFFECT HEALTH (NPI 1780156984) is a healthcare organization registered as a nurse practitioner in Cleveland, Ohio and active in the NPI registry since December 2018. The organization holds a CLIA Waiver certificate valid through January 23, 2027, maintains a secondary practice location in Brooklyn, and lists Seana Rutherford, Owner/operator, as its authorized official.

NPPES Registry Identity

NPI1780156984
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameLAKE EFFECT HEALTH
Location Address3611 PROSPECT AVE ECleveland, OH 44115-2703
Mailing Address3611 Prospect Ave ECleveland, OH 44115-2703 · (440) 289-7584 · Fax (216) 331-6751
Fax(216) 331-6751
Organization SubpartNo
Authorized OfficialSeana RutherfordOwner/operator · (216) 704-1425
Enumeration DateDecember 28, 2018
Last NPPES UpdateSeptember 16, 20244 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2024
NPI 1780156984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

3611 PROSPECT AVE E, Cleveland, OH 44115

Secondary Practice Location 1

Location 17575 Northcliff Ave Ste 103Brooklyn, OH 44144-3267 · Phone (216) 205-4862 · Fax (216) 205-4767

Other Identifiers 1

Medicaid0142912OH

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted 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 36D2161020

Lake Effect Health LLC · Cleveland, OH
Active · expires Jan 23, 2027
CLIA Number36D2161020
Laboratory TypePractitioner Other
Certificate Effective DateJanuary 24, 2025
Certificate Expiration DateJanuary 23, 2027
Laboratory DirectorSeana Rutherford
Laboratory Phone(216) 205-4862
Laboratory LocationLake Effect Health LLC3611 Prospect Avenue E, Cleveland, OH 44115
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

Nurse Practitioner
3611 PROSPECT AVE E
CLEVELAND, OH 44115
Nurse Practitioner (Family)
3611 PROSPECT AVE E
CLEVELAND, OH 44115
Nurse Practitioner
3611 PROSPECT AVE E
CLEVELAND, OH 44115
Nurse Practitioner (Family)
3611 PROSPECT AVE E
CLEVELAND, OH 44115
Nurse Practitioner (Family)
3611 PROSPECT AVE E
CLEVELAND, OH 44115

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 Effect Health's NPI number?

The NPI number for Lake Effect Health is 1780156984. It was assigned to this organization in the NPPES registry on December 28, 2018.

Where is Lake Effect Health located?

Lake Effect Health is located at 3611 Prospect Ave E, Cleveland, OH 44115. The listed phone number is (440) 289-7584.

What is Lake Effect Health's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Lake Effect Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2161020) is associated with this NPI, valid through January 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Effect Health accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Lake Effect Health 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 Effect Health was last updated on September 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.