Ladd F. Koresch O.D., S.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1228-035 Issued in WI

Legal business name

LADD F. KORESCH O.D., S.C.

Practice address

415 Broad St
Suite 101
Lake Geneva, WI 53147-1800

Phone

(262) 248-4878

Fax

(262) 248-1100

NPI assigned

Jun 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ladd F. Koresch, O.D.

Title

Optometrist

Phone

(262) 248-4878

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Mark S Spankowski, OD

  • Optometrist
  • Oconomowoc, WI
  • NPI 1831223338
  NPD (past)

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104029867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BROAD ST",
            "address_2": "SUITE 101",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471800",
            "telephone_number": "262-248-4878",
            "fax_number": "262-248-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BROAD ST",
            "address_2": "SUITE 101",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471800",
            "telephone_number": "262-248-4878",
            "fax_number": "262-248-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LADD F. KORESCH O.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KORESCH",
        "authorized_official_first_name": "LADD",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "262-248-4878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1228-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38556600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joy M Kowalski
• Elena Caraman Krause, MD
• Geetha Priydarshini Krishnan, MD
• Kaitlyn Elise Kurth, DPT
• Amanda Kutis, LAT
• Duanne Lafrenz, MSW, LCSW
• Lake Geneva Chiropractic Partners
• Lake Geneva Dental Care LLC
• Lake Geneva Oral and Maxillofacial Surgery, LTD
• Lake Geneva Wellness Clinic LLC

• Optometrist in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.