Lakeshore Interventional Treatment Center LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

LAKESHORE INTERVENTIONAL TREATMENT CENTER LLC

Practice address

4765 S Lakeshore Dr
Tempe, AZ 85282

Phone

(480) 566-9755

NPI assigned

May 21, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shawn Vigneau, DC

Title

Member

Phone

(480) 556-9755

Specialties & licenses 4

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1043701543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 S LAKESHORE DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827197",
            "telephone_number": "480-566-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 S LAKESHORE DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-566-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE INTERVENTIONAL TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-21",
        "last_updated": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "VIGNEAU",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "480-556-9755",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laesch Consulting LTD
• Brent Laesch, RD, LD.
• Addie E Lafferty, PH.D.
• Laguna Medical Inc
• Charles David Laine, CRNA
• Lakeshore United LLC
• Maggie Trang Lam, DDS
• Martha Lamarre, PA-C
• Charity Omari Lamb
• Patricia Alexis Lamb, RN

• Pain Clinic/Center in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Pain Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.