Lakeshore Medical Center, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LAKESHORE MEDICAL CENTER, P.C.

Practice address

33720 Harper Ave
Suite a
Clinton TWP, MI 48035

Phone

(586) 294-5210

Fax

(586) 294-0215

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

John R Pradko, D.O.NPI 1619956497

Title

Owner

Phone

(586) 294-5210

Specialties & licenses 1

Addresses

Other identifiers 3

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• John R Pradko, D.O.

  • Family Medicine Physician
  • Clinton TWP, MI
  • NPI 1619956497
  NPD (past) Authorized official
• Joseph P Lajoie, D.O.

  • Family Medicine Physician
  • Clarkston, MI
  • NPI 1932179835
  NPD (past)
• James F. Pradko, M.D.

  • Family Medicine Physician
  • Chesterfield, MI
  • NPI 1770558769
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1437239043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33720 HARPER AVE",
            "address_2": "SUITE A",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "48035",
            "telephone_number": "586-294-5210",
            "fax_number": "586-294-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33720 HARPER AVE",
            "address_2": "SUITE A",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "48035",
            "telephone_number": "586-294-5210",
            "fax_number": "586-294-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE MEDICAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "PRADKO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-294-5210",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3223681",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH9022",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4679899",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacey Trent LMSW LLC
• Colleen Lafleur
• Robert J Lage, PTA
• Lake Lazer Eye Center PC
• Lakepointe Senior Care and Rehab Center, LLC
• Donald William Lakin, OD
• Crystal Sue Lamb II, LMSW
• Stephanie Lamerato, LMSW
• Catherine Landa, COTA
• Lisa Lange, RN

• Family Medicine Physician in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.