LAKESIDE MEDICINE AND AESTHETICS LLC
NPI 1851873756
Nurse Practitioner - Primary Care in Sandpoint, ID
NPI Status: Active since September 06, 2018
- Organization
- Nurse Practitioner
- Primary Care
- Accepts Insurance
- CLIA Number: 13D2156095
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 10-09-2026
About LAKESIDE MEDICINE AND AESTHETICS LLC
This page provides the complete NPI Profile along with additional information for Lakeside Medicine And Aesthetics Llc, a provider established in Sandpoint, Idaho operating as a Nurse Practitioner, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1851873756 assigned on September 2018. The practitioner's primary taxonomy code is 363LP2300X with license number NP1029A (ID). The provider is registered as an organization and their NPI record was last updated 7 years ago. Lakeside Medicine And Aesthetics Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Lakeside Medicine And Aesthetics Llc. The authorized official of this NPI record is Kelly Fuhrman Np (Owner/np)
- NPI
- 1851873756
- Provider Legal Name
- LAKESIDE AESTHETICS - LLC
- Other Organization Name
- LAKESIDE MEDICINE AND AESTHETICS LLC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1005 HIGHWAY 2 SANDPOINT, ID 83864
- Location Phone
- (208) 290-3302
- Mailing Address
- PO BOX 333 SAGLE, ID 83860
- Mailing Phone
- (208) 290-3302
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-06-2018
- Last Update Date
- 03-06-2019
- Code Navigator
A nurse practitioner (NP) like Lakeside Medicine And Aesthetics Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Primary Care
- Taxonomy Code
- 363LP2300X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- NP1029A
- License State
- ID
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
| 3 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Connect Bronze Expanded Standard - PPO
- Connect Bronze HDHP - PPO
- Connect Catastrophic - PPO
- Connect Gold - PPO
- Connect Gold Standard - PPO
- Connect Silver - PPO
- Connect Silver Standard - PPO
- High Plains Bronze HDHP - PPO
- High Plains Bronze Standard Expanded - PPO
- High Plains Gold - PPO
- High Plains Gold HDHP - PPO
- High Plains Gold Standard - PPO
- High Plains Silver - PPO
- High Plains Silver Standard - PPO
- Plus Bronze Expanded - PPO
- Plus Bronze Standard Expanded - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- ACCESS BRONZE - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| NP1029A | OTHER (01) | ID | IDAHO STATE LICENSE NUMBER |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 13D2156095
- Facility Type
- Practitioner Other
- Certificate Effective Date
- October 10, 2024
- Certificate Expiration Date
- October 09, 2026
- Laboratory Director
- KELLY A. FUHRMAN BC-ARNP
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lakeside Medicine And Aesthetics Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for LAKESIDE MEDICINE AND AESTHETICS LLC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 5 | 1 | 8 | 7 | 3 | 7 | 5 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 10 | 1 | 16 | 7 | 6 | 7 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 0 + 1 + 1 + 6 + 7 + 6 + 7 + 1 + 0 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1851873756 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1699802553 | SHAWNA ELISA BENNER-ERICKSON MPT Individual | Physical Therapist | 1005 HIGHWAY 2 SANDPOINT, ID 83864 (208) 263-1632 |
| 1194939421 | JOHN MCLAIN FAGGARD III M.D. Individual | Specialist | 1005 HIGHWAY 2 SANDPOINT, ID 83864 (208) 265-5916 |
| 1093253940 | ERICKSON PT ENTERPRISES PLLC Organization | Physical Therapist | 1005 HIGHWAY 2 SANDPOINT, ID 83864 (208) 263-1632 |
| 1750682605 | MRS. KELLY A. FUHRMAN ARNP FNP-BC Individual | Nurse Practitioner (Family) | 1005 HIGHWAY 2 SANDPOINT, ID 83864 (208) 290-3302 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1851873756, enumerated in the NPI registry as an "organization" on September 06, 2018
The provider is located at 1005 Highway 2 Sandpoint, Id 83864 and the phone number is (208) 290-3302
This medical organization specializes in Nurse Practitioner with taxonomy code 363LP2300X with a focus in Primary Care
The provider might be accepting Accepts: Mountain Health CO-OP, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 13D2156095 for a "practitioner other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on September 06, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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