NPIMap

Organization Active NPI

Lakeshore Interventional Pain Associates, LLC

  • Specialist
  • Michigan City, IN
National Provider Identifier
1386823540
Registry record updated May 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01057031A Issued in IN
Legal business name
LAKESHORE INTERVENTIONAL PAIN ASSOCIATES, LLC
Practice address
1507 Wabash St
Suite 400C
Michigan City, IN 46360-4300
Phone
(219) 871-0833
Fax
(219) 871-0836
NPI assigned
Oct 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2009

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

Authorized official

Name
Dr. Jamil Ahmed, MD
Title
Owner
Phone
(219) 871-0833

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 01057031A IN Primary
Case Management Agency 251B00000X 01057031A

Addresses

Primary practice location

1507 Wabash St
Suite 400C
Michigan City, IN 46360-4300

Mailing address

1507 Wabash St
Suite 400C
Michigan City, IN 46360-4300
Phone (219) 871-0833

National Provider Directory

National Provider Directory

Locations

3500 Franciscan Way
#4D
Michigan City, IN 46360

1507 Wabash St
Ste 400C
Michigan City, IN 46360
Phone (219) 871-0833

3500 Franciscan Way
Ste 4E
Michigan City, IN 46360

3500 Franciscan Way
Fl 4
Michigan City, IN 46360
Phone (219) 871-0833

3500 Franciscan Way
Fl 4D
Michigan City, IN 46360

1507 Wabash St
#400C
Michigan City, IN 46360
Phone (219) 870-8333

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1386823540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 WABASH ST",
            "address_2": "SUITE 400C",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463604300",
            "telephone_number": "219-871-0833",
            "fax_number": "219-871-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 WABASH ST",
            "address_2": "SUITE 400C",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463604300",
            "telephone_number": "219-871-0833",
            "fax_number": "219-871-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE INTERVENTIONAL PAIN ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2009-05-05",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "JAMIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-871-0833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IN",
            "license": "01057031A",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": "01057031A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; 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.