Laker Prosthetics

Primary specialty

ProsthetistTaxonomy code 224P00000X

Legal business name

LAKER PROSTHETICS

Practice address

5181 Plainfield Ave NE
Suite D
Grand Rapids, MI 49525

Phone

(616) 490-8564

Fax

(616) 469-2962

NPI assigned

Jan 3, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Sean Paul Taylor, CPNPI 1083864342

Title

Owner

Phone

(616) 490-8564

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

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

• Sean Paul Taylor, CERTIFIED PROSTETIST

  • Customized Equipment (DME)
  • Belmont, MI
  • NPI 1083864342
  NPD Authorized official

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563148800000",
    "number": "1154894046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5181 PLAINFIELD AVE NE",
            "address_2": "SUITE D",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-490-8564",
            "fax_number": "616-469-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5181 PLAINFIELD AVE NE",
            "address_2": "SUITE D",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-490-8564",
            "fax_number": "616-469-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKER PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-07-15",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-490-8564",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABC",
            "identifier": "CP03634",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sean@Lakerprosthetics.com",
            "affiliation": "N",
            "address_1": "5181 Plainfield Ave NE",
            "address_2": "Suite D",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexander Joseph Lake, DO
• Candice M Lake, BCBA-D, LLP
• Dennis Lake, M.D.
• Eric S Lake, MA,LLP, CADC
• Suzanne Rae Lake, RPH
• Lakeshore Opticians
• Nehal Jagdish Lakhani, M.D.
• Govinda Sai Lakshmanan
• Julia Katherine Lalain
• Keshav Lalchandani

• Prosthetist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Prosthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.