Lakeside Chiropractic, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

1724 Issued in AR

Legal business name

LAKESIDE CHIROPRACTIC, PLLC

Practice address

5 Shiloh Rd
Higden, AR 72067-9521

Phone

(501) 825-7200

NPI assigned

Sep 12, 2016

Last updated

Jan 9, 2023By 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

William Jacob Smith, DONPI 1154701480

Title

Owner

Phone

(501) 825-7200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 6

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.

• William Jacob Smith, D.C

  • Chiropractor
  • Greers Ferry, AR
  • NPI 1154701480
  Medicare reassignment NPD Authorized official
• April Rene Fletcher, APRN

  • Family Nurse Practitioner
  • Mountain View, AR
  • NPI 1497645220
  NPD
• Alan B Carnathan, DC

  • Chiropractor
  • Greers Ferry, AR
  • NPI 1730261223
  NPD (past)
• Gary Shawn Fletcher, D.C.

  • Chiropractor
  • Mountain View, AR
  • NPI 1467600759
  NPD (past)
• Kelli Love Harris, DC

  • Chiropractor
  • Heber Springs, AR
  • NPI 1801978325
  NPD (past)
• Peter H Harris, DC

  • Chiropractor
  • Heber Springs, AR
  • NPI 1740362235
  NPD (past)

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1639627284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "HIGDEN",
            "state": "AR",
            "postal_code": "720670115",
            "telephone_number": "501-825-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SHILOH RD",
            "city": "HIGDEN",
            "state": "AR",
            "postal_code": "720679521",
            "telephone_number": "501-825-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-825-7200",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": "1724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Confidential Counseling LLC
• Cristy Depriest, CRT
• Laura Nicole Hall, LPC

• Clinic/Center in Higden, AR
• Providers in Higden, AR by specialty
• Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.