Lakeshore Vision Centers LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

LAKESHORE VISION CENTERS LTD

Practice address

1217 Ellis St
Kewaunee, WI 54216

Phone

(920) 388-2020

Fax

(920) 388-3594

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Susan A Gorz, ODNPI 1427033034

Title

Co Owner Vice President

Phone

(920) 487-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lakeshore Vision Centers, LTD

  • Clinic/Center
  • Algoma, WI
  • NPI 1780734418

  O20080117000651

  Same enrollment

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Ann Gorz, OD

  • Optometrist
  • Kewaunee, WI
  • NPI 1427033034
  NPD Authorized official
• John Edward Gorz, OD

  • Optometrist
  • Algoma, WI
  • NPI 1295710515
  NPD

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1073663704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 ELLIS ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "54216",
            "telephone_number": "920-388-2020",
            "fax_number": "920-388-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 ELLIS ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "54216",
            "telephone_number": "920-388-2020",
            "fax_number": "920-388-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE VISION CENTERS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2009-04-22",
        "status": "A",
        "authorized_official_last_name": "GORZ",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO OWNER VICE PRESIDENT",
        "authorized_official_telephone_number": "920-487-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000047383",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kewaunee Chiropractic Works LLC
• Kewaunee Hometown Pharmacy LLC
• Kewaunee School District
• Kelly J Kovnesky, LPC-IT
• Jacob Kumpfer, LMFT-IT
• Robin Lambrecht, LPC
• Shanna Larochelle
• Carol Jean Lenius, ECEEN BS EDUCATION
• Shawn R Leonardson, BS
• Mark A Letter, DDS

• Clinic/Center in Kewaunee, WI
• Providers in Kewaunee, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.