Lakeshore Eye Consultants, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

LAKESHORE EYE CONSULTANTS, LLC

Doing business as

Lakeshore Eye Consultants

Practice address

1225 E Coolspring Ave
Michigan City, IN 46360-6312

Phone

(765) 414-3876

NPI assigned

Aug 20, 2020

Last updated

Aug 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marc Booth, M.D.

Title

Owner/Physician

Phone

(765) 414-3876

Specialties & licenses 1

Addresses

Other names 1

• Lakeshore Eye Consultants Doing business as

Locations

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1073125076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "765-414-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "765-414-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE EYE CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "765-414-3876",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeshore Eye Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lake Effect Healing PC
• Lakeshore Bone & Joint Institute, PC
• Lakeshore Cardiovascular Institute LLC
• Lakeshore Eye Specialists PC
• Lakeshore Family Dental, P.C.
• Lakeshore Interventional Pain Associates, LLC
• Gregoria B Landicho, MD
• Christie Ann Lant, DDS

• Ophthalmology Physician in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.