Lakeside Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

627 Issued in AR

Legal business name

LAKESIDE PHYSICAL THERAPY, INC.

Practice address

1221 County Road 157
Eureka Springs, AR 72632-9343

Phone

(479) 253-1711

Fax

(215) 261-0814

NPI assigned

May 5, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Richard V. Goodier, R. P. T.

Title

President

Phone

(479) 253-1711

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508078056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 COUNTY ROAD 157",
            "city": "EUREKA SPRINGS",
            "state": "AR",
            "postal_code": "726329343",
            "telephone_number": "479-253-1711",
            "fax_number": "215-261-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 COUNTY ROAD 157",
            "city": "EUREKA SPRINGS",
            "state": "AR",
            "postal_code": "726329343",
            "telephone_number": "479-253-1711",
            "fax_number": "215-261-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOODIER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-253-1711",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R. P. T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Ray Jones, M.D.
• Kenneth H. Covington DDS
• Jon Michael Krannichfeld, M.D.
• Cynthia Kresse
• Gregory Kresse
• Neal Christopher Lawrence, M.D.
• Nathan Lipe, O.D.
• Adam Marinus Louderback, MHPP
• Jon Del Loudermilk, M.D.
• LTC of Eureka Springs, LLC

• Physical Therapist in Eureka Springs, AR
• Providers in Eureka Springs, AR by specialty
• Physical Therapist in Arkansas

• 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.