OrganizationActive
Lake Hospital System, Inc.
NPI 1174762512 · Family Medicine Physician · Perry, OH
Provider details
- NPI number
- 1174762512
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Robert Tracz, Chief Financial Officer(440) 354-1642
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2 Success Blvd.
Perry, OH 44081
Phone: (440) 375-8590
Fax: (440) 259-2106
Street-level locationGet directions
Mailing address
Po Box 714328
Columbus, OH 43271-4328
Other names (DBA / former)
- Doing business as
- Primehealth Perry Health and Wellness Center
Registry dates
- Enumerated
- 2009-02-09
- Last updated
- 2009-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.