Lakeshore Medical Clinic, LTD.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAKESHORE MEDICAL CLINIC, LTD.

Practice address

4131 W Loomis Rd
Ste 200
Greenfield, WI 53221-2051

Phone

(414) 281-5151

NPI assigned

Nov 1, 2006

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

Masood Wasiullah, MD

Title

President/Ceo

Phone

(414) 764-3241

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Hustisford, WI
  • NPI 1528193174

  Member Of

  NPD member

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396822854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "STE 200",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212051",
            "telephone_number": "414-281-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "STE 200",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212051",
            "telephone_number": "414-281-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE MEDICAL CLINIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WASIULLAH",
        "authorized_official_first_name": "MASOOD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "414-764-3241",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Lafleur, MS, EDS, CSAC
• Prasanta K Lahiri, MD
• Lakeshore Medical Clinic
• Lakeshore Medical Clinic LLC
• Lakeshore Medical Clinic, LTD
• Lakeshore Neurowellness & Rehab Center
• Michael Ryan Lamp, DNP
• Erica M Landgraf, NP
• Rebecca Lynn Landgraf, MA CCCA
• Landmark Recovery of Greenfield LLC

• Durable Medical Equipment & Medical Supplies in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• 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.