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Family Practice By the Lake LLC

Family Medicine Physician in Coeur D Alene, ID · enumerated 2016 · authorized official Jacqueline Wagner, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1295283810

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Registry record

Entity type Organization (Type 2)
Legal business name Family Practice By the Lake LLC
Practice address 1875 N Lakewood Dr Ste 205, Coeur D Alene, ID, 83814
Phone (208) 966-4087
Fax (208) 966-4031
Enumeration date Sep 12, 2016
Last updated in NPPES Mar 25, 2024

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary
363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Jacqueline Wagner
Title Owner
Phone (208) 661-1181

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Family Practice By the Lake LLC?
The NPI for Family Practice By the Lake LLC is 1295283810, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Family Practice By the Lake LLC?
NPPES lists Jacqueline Wagner (Owner) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-03-25.