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LAKESIDE PEDIATRICS PLLC NPI 1104880426


NPI Information

NPI: 1104880426
Provider Name: LAKESIDE PEDIATRICS, PLLC

Former Legal Business Name: HAGAN, RINEHART & CONNOLLY PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
128 LAKESIDE AVE
SUITE 115
BURLINGTON, VT
ZIP 05401
Phone: (802) 860-1928
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LAKESIDE PEDIATRICS, PLLC is a pediatrics in Burlington, VT. The provider is 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. LAKESIDE PEDIATRICS, PLLC NPI is 1104880426. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Hagan, Rinehart & Connolly Pediatrics.

The provider's business location address is:

128 LAKESIDE AVE
SUITE 115
BURLINGTON, VT
ZIP 05401-939
Phone: (802) 860-1928
Fax: (802) 860-0192

The provider's authorized official is Lynn Bergeron .
The authorized official title is Business Office Manager and has the following contact phone number (802) 860-1928.

The enumeration date for this NPI number is 4/13/2006 and was last updated on 8/27/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics0420006081VERMONTYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
133869OTHERVERMONTMVP
21007673MEDICAIDVERMONT
358026HAGAOTHERVERMONTBCBS

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

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