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LAKE COUNTRY PHYSICIANS
NPI 1801849963
Pediatrics in Oconomowoc, WI

Active since May 18, 2006CLIA 52D0937038 · Waiver
970 S SILVER LAKE ST, STE. 102, OCONOMOWOC, WI 53066(262) 569-7100(262) 567-6295 Get Directions Write a Review

NPPES record last updated: August 15, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lake Country Physicians NPPES

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

LAKE COUNTRY PHYSICIANS (NPI 1801849963) is a healthcare organization registered as a pediatrics in Oconomowoc, Wisconsin and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through July 7, 2028 and lists Gregory M Moyer, Dr., as its authorized official.

NPPES Registry Identity

NPI1801849963
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameLAKE COUNTRY PEDIATRICS SC
Location Address970 S SILVER LAKE ST, STE. 102Oconomowoc, WI 53066-3802
Mailing Address970 S Silver Lake St, Ste. 102Oconomowoc, WI 53066-3802 · (262) 569-7100 · Fax (262) 567-6295
Phone(262) 569-7100
Fax(262) 567-6295
Organization SubpartNo
Authorized OfficialGregory M MoyerDr. · (262) 569-7100
Enumeration DateMay 18, 2006
Last NPPES UpdateAugust 15, 2011
✔ NPI 1801849963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in WI · 35710
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
970 S SILVER LAKE ST, Oconomowoc, WI 53066
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Other Names 1

Doing Business AsLake Country Physicians

Other Identifiers 1

Medicaid21250600WI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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 52D0937038

Lake Country Pediatrics, Sc · Oconomowoc, WI
Active · expires Jul 7, 2028
CLIA Number52D0937038
Laboratory TypePhysician Office
Certificate Effective DateJuly 8, 2026
Certificate Expiration DateJuly 7, 2028
Laboratory DirectorDr. Gregory M. Moyer
Laboratory Phone(262) 569-7100
Laboratory LocationLake Country Pediatrics, Sc970 S Silverlake St Ste 102, Oconomowoc, WI 53066
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

DR. TIMOTHY G. WILLIAMSON DDS
Dentist (General Practice)
970 S SILVER LAKE ST
OCONOMOWOC, WI 53066
Waukesha County (262) 567-7400
BONITA JEAN DEBBAN PH.D
Psychologist
970 S SILVER LAKE ST
OCONOMOWOC, WI 53066
Waukesha County (262) 567-7900
DR. CHRISTIAN ZEBRASKY D.C.
Chiropractor
970 S SILVER LAKE ST, SUITE 106
OCONOMOWOC, WI 53066
Waukesha County (262) 560-9400
A NEW DAY PSYCHOLOGICAL SERVICES LLC
Psychologist (Clinical)
970 S SILVER LAKE ST, SUITE 103
OCONOMOWOC, WI 53066
Waukesha County (262) 567-7900
MRS. DEBORAH J KLECKER LPC, MFT-IT, SAC-IT
Counselor (Professional)
970 S SILVER LAKE ST, SUITE #103
OCONOMOWOC, WI 53066
Waukesha County (262) 567-7377
DR. GREGORY MICHAEL MOYER M.D.
Pediatrics
970 S SILVER LAKE ST, STE. 102
OCONOMOWOC, WI 53066
Waukesha County (262) 569-7100
LAKE COUNTRY PAIN TREATMENT
Specialist
970 S SILVER LAKE ST, SUITE 106
OCONOMOWOC, WI 53066
Waukesha County (262) 560-9400
COMPLETE CHIROPRACTIC AND REHAB CENTER LLC
Chiropractor
970 S SILVER LAKE ST, #106
OCONOMOWOC, WI 53066
Waukesha County (262) 560-9400

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 Country Pediatrics Sc's NPI number?

The NPI number for Lake Country Pediatrics Sc is 1801849963. It was assigned to this organization in the NPPES registry on May 18, 2006. The provider is doing business as Lake Country Physicians.

Where is Lake Country Pediatrics Sc located?

Lake Country Pediatrics Sc is located at 970 S Silver Lake St Ste. 102, Oconomowoc, WI 53066. The listed phone number is (262) 569-7100.

What is Lake Country Pediatrics Sc's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Lake Country Pediatrics Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0937038) is associated with this NPI, valid through July 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Country Pediatrics Sc accept?

Health plans from Anthem Blue Cross and Blue Shield list Lake Country Pediatrics Sc 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 Country Pediatrics Sc was last updated on August 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.