Lakeside Integrated Group, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5133 Issued in GA

Legal business name

LAKESIDE INTEGRATED GROUP, LLC

Practice address

1864 Thompson Bridge Road
Gainesville, GA 30501

Phone

(770) 538-0330

Fax

(770) 535-0643

NPI assigned

Aug 31, 2015

Last updated

Aug 31, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Terry Crews III, D.C.NPI 1184707713

Title

President

Phone

(770) 538-0330

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Terry Crews III, D.C.

  • Chiropractor
  • Gainesville, GA
  • NPI 1184707713
  NPD (past) Authorized official

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1336516947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1864 THOMPSON BRIDGE RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011119",
            "telephone_number": "770-538-0330",
            "fax_number": "770-535-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 THOMPSON BRIDGE ROAD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-538-0330",
            "fax_number": "770-535-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE INTEGRATED GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "CREWS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-538-0330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "5133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ramsland Lake, OTR/L
• Lakeshore Chiropratic
• Lakeshore Mall Dental Group
• Lakeshore Tubal Reversal Center (Lakeshore Surgical Center)
• Lakeside Family Medicine
• Lakeside OB/GYN and Pelvic Surgery, LLC
• Sanjay M Lall, M.D.
• Christine D Lallos, MD
• Hamilton Vo Lam, M.D., MPH
• Linh My Lam

• Chiropractor in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.