Lake Shore Nursing Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LAKE SHORE NURSING HOME

Practice address

845 Routes 5 and 20
Irving, NY 14081-9714

Phone

(716) 951-7060

NPI assigned

Mar 19, 2007

Last updated

Aug 22, 2020By 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

John Schreier

Title

Senior VP, Cfo

Phone

(716) 951-7147

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376667782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12644 SENECA RD",
            "city": "IRVING",
            "state": "NY",
            "postal_code": "140819714",
            "telephone_number": "716-951-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 ROUTES 5 AND 20",
            "city": "IRVING",
            "state": "NY",
            "postal_code": "140819714",
            "telephone_number": "716-951-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SHORE NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHREIER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SENIOR VP, CFO",
        "authorized_official_telephone_number": "716-951-7147"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00475163",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Karstedt, PA-C
• Heidi Lynne Kazmark, CASAC-T
• Jason Christopher Kloc, P.T.
• Corinne P Krist, D.O.
• Lake Shore Child Care Center, Inc (Lake Shore Family Center)
• Lakeshore Medical Care, PC (Lakeshore Eye Care)
• Lakeshore Orthopedic Group P.C.
• Kelsey Marie Lay
• Elizabeth Ann Lyboult, PHARM. D.
• Nicole Maciejewski, PTA

• Skilled Nursing Facility in Irving, NY
• Providers in Irving, NY by specialty
• Skilled Nursing Facility in New York

• 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.