Lakeside Pain Center Prof. LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

LAKESIDE PAIN CENTER PROF. LLC

Practice address

1512 4TH St NE
Watertown, SD 57201-6824

Phone

(605) 884-0100

NPI assigned

Apr 20, 2022

Organization subpart

No

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

Authorized official

Name

Austin J Beck, DONPI 1437689965

Title

Physician

Phone

(605) 884-0100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Austin J Beck, D.O.

  • Interventional Pain Medicine Physician
  • Watertown, SD
  • NPI 1437689965
  Medicare reassignment Care Compare group NPD Authorized official
• Allison Theresa Tracy, FNP-C

  • Family Nurse Practitioner
  • Watertown, SD
  • NPI 1114609104
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1295478907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 4TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016824",
            "telephone_number": "605-884-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 4TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016824",
            "telephone_number": "605-884-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PAIN CENTER PROF. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "605-884-0100",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kunkel-Snyder Optometric, P.C
• Beth Ann Kunkel, O.D.
• Matthew Charles Kunkel, O.D.
• Roy Lagat
• Jacalynn L Lake, PT
• Janet Lamb Even, LPC
• Zachary Eugene Lambrechts, DPT
• Janette Theresa Laplante, MS CCDC MAC
• Alyssa Larson
• Angela Renae Larson, BS

• Pain Clinic/Center in Watertown, SD
• Providers in Watertown, SD by specialty
• Pain Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.