Lakeside Family Practice
NPI 1831698430ActiveOrganization· Nurse Practitioner, Family· Kenosha, WI
Nurse Practitioner, Family in Kenosha, Wisconsin, registered in NPPES in February 2018. The authorized official on file is Anthony Hale, DNP, FNP-BC, Owner.
Overview
| NPI | 1831698430 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 8, 2018 |
| Last updated in NPPES | Feb 8, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | 2011006054 | WI |
| Nurse Practitioner, Gerontology | 363LG0600X | 6190-33 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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