Lake Breeze ENT & Allergy PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

2011-01689 Issued in NC

Legal business name

LAKE BREEZE ENT & ALLERGY PC

Practice address

149 Plantation Ridge Dr
Suite 190
Mooresville, NC 28117-9174

Phone

(713) 818-0590

NPI assigned

Mar 23, 2012

Organization subpart

No

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

Authorized official

Name

Roy Sheldon Lewis, M.D.

Title

President

Phone

(713) 818-0590

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1487920443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 PLANTATION RIDGE DR",
            "address_2": "SUITE 190",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179174",
            "telephone_number": "713-818-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 PLANTATION RIDGE DR",
            "address_2": "SUITE 190",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179174",
            "telephone_number": "713-818-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE BREEZE ENT & ALLERGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-23",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "SHELDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-818-0590",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "2011-01689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• L a Lorenzo MD Pathology Consult Services P a
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• Andrea Jo Ladowski, MSOTR/L
• Kathleen Wilkin Lagesse, AGNP-C
• Patrick Jacques Laguerre, M.D.
• Lake Norman Anesthesia Associates
• Lake Norman Bariatrics
• Lake Norman Child and Adolescent Psychiatry
• Lake Norman Chiropractic Center
• Lake Norman Chiropractic Center, PA

• Otolaryngology Physician in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Otolaryngology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.