Family Practice By the Lake LLC
NPI 1295283810 · Family Medicine Physician · Coeur D Alene, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Family Practice By the Lake LLC is a Family Medicine Physician organization in Coeur D Alene, ID (NPI 1295283810).
Provider details
- NPI number
- 1295283810
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jacqueline Wagner, Owner(208) 661-1181
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
Mailing address
Registry dates
- Enumerated
- 2016-09-12
- Last updated
- 2024-03-25
- Certified
- 2024-03-25
Frequently asked questions
- What is Family Practice By the Lake LLC's NPI number?
- Family Practice By the Lake LLC's National Provider Identifier (NPI) is 1295283810, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Family Practice By the Lake LLC?
- Family Practice By the Lake LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Family Practice By the Lake LLC located?
- Family Practice By the Lake LLC's practice location on file with NPPES is 1875 N Lakewood Dr Ste 205, Coeur D Alene, ID 83814-4928.
- What is Family Practice By the Lake LLC's phone number?
- The practice phone number listed in the NPPES registry for Family Practice By the Lake LLC is (208) 966-4087.
- Does Family Practice By the Lake LLC accept Medicare?
- Family Practice By the Lake LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Family Practice By the Lake LLC?
- The authorized official listed on Family Practice By the Lake LLC's NPPES record is Jacqueline Wagner, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Family Practice By the Lake LLC's NPI active?
- Yes — Family Practice By the Lake LLC's NPI (1295283810) is active in the NPPES registry as of the last update on 2024-03-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.