LAKESHORE MEDICAL CLINIC LLC (NPI# 1265597645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265597645 |
| Entity Type | Organization |
| Organization Name | LAKESHORE MEDICAL CLINIC LLC |
| Practice Address |
5900 S Lake Dr Cudahy WI 53110-3171 |
| Practice Telephone | 4144894190 |
| Mailing Telephone | 4144894190 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2017-04-06 |
| Authorized Official Name | MIKE BANIA (ADMINISTRATOR) |
| Authorized Official Telephone | 4147446589 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538351549 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 4448 W Loomis Rd Ste 204, Greenfield, WI 53220-4851 | 2007-08-14 |
| 1154840163 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 200 E Ryan Rd, Oak Creek, WI 53154-4563 | 2017-09-12 |
| 1497983837 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 4202 W Oakwood Park Ct, Franklin, WI 53132-8131 | 2009-06-24 |
| 1639374036 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 331 E Puetz Rd, Oak Creek, WI 53154-3254 | 2007-06-18 |
| Street Address |
5900 S LAKE DR |
| City | CUDAHY |
| State | WI |
| Zip Code | 53110-3171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073513974 | Allan Richard Pasch | Surgery | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2005-07-21 |
| 1386268977 | Dawn Sheffield | Social Worker | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2020-05-30 |
| 1114546470 | Ally Marthaler-gerads | Physical Therapist | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2020-04-15 |
| 1689293219 | Hilary Korb | Physical Therapist | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2020-04-14 |
| 1699394213 | Cynthia Faulkner Cook | Physical Therapist | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2020-04-14 |
| 1437655438 | Kimberly J Gehrig | Nurse Practitioner | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2018-03-30 |
| 1346792181 | Kathryn Merkel | Nurse Practitioner | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2016-10-27 |
| 1487004172 | Ben M Ramirez | Nurse Practitioner | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2016-06-14 |
| 1366838203 | Cameron M Malone | Hospitalist | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2015-04-07 |
| 1174917199 | Alyssa Kaleta | Internal Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2015-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1497191357 | Kristel Roebbeke | Occupational Therapist | 4157 W College Ave, Milwaukee, WI 53110 | 2013-05-20 |
| 1568684058 | City of Cudahy | Case Management | 5050 South Lake Drive, Cudahy, WI 53110 | 2007-05-03 |
| 1104854363 | Mathew George Mathai | Internal Medicine | 5900 S. Lake Dr., Cudahy, WI 53110 | 2006-06-28 |
| 1235355983 | Aurora Health Care Metro, Inc. | Clinic/Center | 5900 S Lake Drive, Cudahy, WI 53110 | 2007-04-18 |
| 1386722817 | Ami Prag | Family Medicine | 5900 S Lake Drive, #100, Cudahy, WI 53110 | 2006-11-01 |
| 1689780462 | Jack Avak Tertadian | Internal Medicine | 5900 S. Lake Drive, Cudahy, WI 53110 | 2006-08-22 |
| 1326205162 | Edward J Tomasik & Associate Optometrists Inc. | Durable Medical Equipment & Medical Supplies | 3552 E Layton Ave, Cudahy, WI 53110-0200 | 2008-05-20 |
| 1609171453 | Stat Access | Nursing Care | 3429 E Allerton Ave, Cudahy, WI 53110-1017 | 2011-01-25 |
| 1790314599 | John Hoehn | Social Worker | 3754 E Allerton Ave, Cudahy, WI 53110-1109 | 2020-04-03 |
| Find all providers in zip 53110 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1780742312 | Homestead Independence Inc | Durable Medical Equipment & Medical Supplies | 1995 E Norse Ave, Cudahy, WI 53110-4835 | 2006-12-05 |
| 1770661282 | Sgp Incorporated | Durable Medical Equipment & Medical Supplies | 7705 S Atlantic Blvd, H, Cudahy, CA 90201 | 2006-11-01 |
| 1265449144 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3201 E Layton Ave, Cudahy, WI 53110-1402 | 2006-08-02 |
| 1295740181 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6241 S Packard Ave, Cudahy, WI 53110-3031 | 2006-07-29 |
| 1710299466 | Aurora Health Care Metro, Inc | Durable Medical Equipment & Medical Supplies | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2010-07-10 |
| 1205044906 | Aurora Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 5900 S Lake Dr, Cudahy, WI 53110-3171 | 2007-05-18 |
| 1790998581 | Ophthalmology Associates | Durable Medical Equipment & Medical Supplies | 6020 S Packard Ave, Cudahy, WI 53110-3028 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659983070 | Midwest Respiratory Care Inc | Durable Medical Equipment & Medical Supplies | 507 Jefferson St E # 34, West Salem, WI 54669-9560 | 2020-08-18 |
| 1356959506 | A Journey Home Medsupply | Durable Medical Equipment & Medical Supplies | 9575 W Fond Du Lac Ave Apt 19, Milwaukee, WI 53225-1645 | 2020-07-14 |
| 1801410097 | Discountramps.com LLC | Durable Medical Equipment & Medical Supplies | N102w19400 Willow Creek Way, Germantown, WI 53022-3703 | 2020-06-03 |
| 1861016404 | Active Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1233 N Mayfair Rd Ste 120, Wauwatosa, WI 53226-3255 | 2020-05-29 |
| 1114551165 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3536 52nd St Ste P, Kenosha, WI 53144-2662 | 2020-02-28 |
| 1972137842 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 4635 W College Ave Ste 114, Appleton, WI 54914-8507 | 2020-02-28 |
| 1104458140 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 1818 S. Rapids Rd, Manitowoc, WI 54220-9302 | 2020-02-07 |
| 1619511599 | Xceed Medical, LLC | Durable Medical Equipment & Medical Supplies | 5307 S 92nd St Ste 125, Hales Corners, WI 53130-1677 | 2019-11-04 |
| 1922641877 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | W234s3555 Les Paul Pkwy, Waukesha, WI 53189-8512 | 2019-10-23 |
| 1720629504 | Layton Pharmacy Sc | Durable Medical Equipment & Medical Supplies | 2741 W Layton Ave Ste 105, Milwaukee, WI 53221-2600 | 2019-10-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.