LAKEVIEW SURGERY CENTER LC NPI 1003807835

NPI Information

NPI: 1003807835
Provider Name: LAKEVIEW SURGERY CENTER LC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 16D0987720

Address:
1750 60TH STREET
WEST DES MOINES, IA
ZIP 50266
Phone: (515) 273-5240
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LAKEVIEW SURGERY CENTER LC is an ambulatory surgical clinic center in West Des Moines, IA. LAKEVIEW SURGERY CENTER LC NPI is 1003807835. The provider is registered as an organization entity type.

The provider's business location address is:

1750 60TH STREET
WEST DES MOINES, IA
ZIP 50266
Phone: (515) 273-5240
Fax: (515) 273-5241

The provider's authorized official is Michael P Mohan .
The authorized official title is Board Chair and has the following contact phone number (515) 270-5240.

The CLIA number assigned to this NPI record is 16D0987720 - ambulatory surgery center with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 11/1/2005 and was last updated on 1/27/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical		IOWA	No
2	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	61002	OTHER	IOWA	BLUE SHIELD PROVIDER NUMB
2	0610089	MEDICAID	IOWA
3	I5615	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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