NPI age
19 years
Enumerated 2006-12-06
● Active Type 2 · Organization
Lakeside Pediatric & Adolescent Medicine, Pllc
Lakeside Pediatric & Adolescent Medicine, Pllc is 1 of 13 pediatrics organizations in Idaho.
Primary specialty
Pediatrics
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Vanhook
Office Manager
Last NPPES update
2012-07-12
Source: monthly bulk 2026-05
How this organization compares
Across 13 active pediatrics providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-12Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
980 W Ironwood Dr, Ste 302
Coeur D'Alene, ID 838142601
Mailing address
980 W Ironwood Dr, Ste 302
Coeur D'Alene, ID 838142601
Authorized official
Diana R Vanhook
Office Manager
📞 2082925437
Specialties
-
Pediatrics PrimaryA pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806408200 | |
| 01 (ID) | 4010138351 | REGENCE BLUE SHIELD GROUP |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.