Lakeside Neurocare Limited.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

LAKESIDE NEUROCARE LIMITED.

Practice address

430 E Division St
Fond Du Lac, WI 54935-4560

Phone

(920) 923-5526

Fax

(920) 923-5871

NPI assigned

Aug 14, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Susan M Golden, CPC

Title

Business Manager

Phone

(920) 223-5582

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1225220254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W 9TH AVE STE 225",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047865",
            "telephone_number": "920-223-5580",
            "fax_number": "920-223-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-923-5526",
            "fax_number": "920-923-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE NEUROCARE LIMITED.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "GOLDEN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "920-223-5582",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32820600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tai H Kwon, MD
• Carin M Lacount, OD
• Luanne Laib
• Lakeland Care Inc
• Lakeside Neurocare
• Lakeview Transportation, Inc.
• Madhulika Lall, MD
• Victoria L Lamb, MS CCC-SLP
• Eugene K Lambert, MD
• Denise Landkamer

• Neurology Physician in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Neurology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.