Lakeside Healthcare Specialists PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MS007105 Issued in MI

Legal business name

LAKESIDE HEALTHCARE SPECIALISTS PLLC

Practice address

3950 Hollywood Rd
Suite 270
Saint Joseph, MI 49085-9159

Phone

(269) 983-0500

Fax

(269) 429-2240

NPI assigned

Nov 22, 2006

Last updated

Feb 3, 2016By 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

Sharon Deskins, MDNPI 1275592537

Title

Physician Owner

Phone

(269) 983-0500

Specialties & licenses 8

Addresses

Other identifiers 2

Locations

Practitioners 7

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.

• Sharon Deskins, M.D.

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1275592537
  Authorized official Same address or phone
• Kathleen M Andries, MD

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1588623276
  NPD (past)
• Barbara Heenan, NP

  • Nurse Practitioner
  • Saint Joseph, MI
  • NPI 1275629727
  NPD (past)
• David A Puzycki, MD

  • Internal Medicine Physician
  • Eau Claire, MI
  • NPI 1952478281
  NPD (past)
• Deanna Margaret Rucano, NP

  • Nurse Practitioner
  • Saint Joseph, MI
  • NPI 1174011316
  NPD (past)
• Vijaya Shastri, MD

  • Adolescent Medicine (Internal Medicine) Physician
  • Saint Joseph, MI
  • NPI 1245299502
  NPD (past)
• Susan D. Weinstein, D.O.

  • Internal Medicine Physician
  • South Burlington, VT
  • NPI 1467411769
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1467527648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD",
            "address_2": "SUITE 270",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859159",
            "telephone_number": "269-983-0500",
            "fax_number": "269-429-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD",
            "address_2": "SUITE 270",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859159",
            "telephone_number": "269-983-0500",
            "fax_number": "269-429-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE HEALTHCARE SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "DESKINS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "269-983-0500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "SD062237",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "KA036485",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "AP062392",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "SW015533",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "DP065168",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "MS007105",
            "primary": true
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "MI",
            "license": "VS046079",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "SS036858",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CG8207",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0A110280",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeland Physician Care Network
• Lakeshore Acupuncture, LLC
• Lakeshore Anesthesia Staffing LLC
• Lakeside Cancer Specialists, PLLC
• Lakeside Diabetes & Endocrine Center PLLC
• Lakeside Pulmonary Medicine PLLC
• Lakeside Urology PC
• Kara Lampinen, CCC-SLP
• William Lon Peterson Lancaster, PA-C
• Isabella Assunta Lane, DO

• Internal Medicine Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.