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LAKESHORE PEDIATRICS PC
NPI 1801238787
Clinic/Center - Rural Health in Moulton, AL

Active since July 22, 2013
12521 AL HIGHWAY 157 STE B, MOULTON, AL 35650(256) 974-6300 Get Directions Write a Review

NPPES record last updated: July 22, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lakeshore Pediatrics Pc NPPES

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

LAKESHORE PEDIATRICS PC (NPI 1801238787) is a healthcare organization registered as a rural health in Moulton, Alabama and active in the NPI registry since July 2013. The organization lists Agustin Rivas, Owner, as its authorized official.

NPPES Registry Identity

NPI1801238787
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameLAKESHORE PEDIATRICS PC
Location Address12521 AL HIGHWAY 157 STE BMoulton, AL 35650-1937
Mailing Address1120 S Jackson Hwy Ste 304Sheffield, AL 35660-5773 · (256) 386-4151
Phone(256) 974-6300
Organization SubpartNo
Authorized OfficialAgustin RivasOwner · (256) 386-4151
Enumeration DateJuly 22, 2013
✔ NPI 1801238787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in AL · 17108
12521 AL HIGHWAY 157 STE B, Moulton, AL 35650
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Other Identifiers 1

Medicaid1588002455AL

Other Providers at the Same Location NPPES

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

LAKESHORE PEDIATRICS PC
Pediatrics
12521 AL HIGHWAY 157 STE B
MOULTON, AL 35650
Lawrence County (256) 974-6300

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 Lakeshore Pediatrics PC's NPI number?

The NPI number for Lakeshore Pediatrics PC is 1801238787. It was assigned to this organization in the NPPES registry on July 22, 2013.

Where is Lakeshore Pediatrics PC located?

Lakeshore Pediatrics PC is located at 12521 Al Highway 157 Ste B, Moulton, AL 35650. The listed phone number is (256) 974-6300.

What is Lakeshore Pediatrics PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Lakeshore Pediatrics PC was last updated on July 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.