Lakeside Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LAKESIDE CHIROPRACTIC LLC

Practice address

5024 Green Bay Rd Ste 100
Kenosha, WI 53144-1702

Phone

(262) 657-8434

Fax

(262) 657-8435

NPI assigned

Feb 13, 2020

Organization subpart

No

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

Authorized official

Name

Jaynie Gossett

Title

Billing Coordinator

Phone

(262) 657-8434

Specialties & licenses 1

Addresses

Practitioners 1

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

• Tyler Wayne Vitzthum, D.C.

  • Chiropractor
  • Fairfield, CT
  • NPI 1245686997
  NPD

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1669005013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5024 GREEN BAY RD STE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441702",
            "telephone_number": "262-657-8434",
            "fax_number": "262-657-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5024 GREEN BAY RD STE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441702",
            "telephone_number": "262-657-8434",
            "fax_number": "262-657-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "GOSSETT",
        "authorized_official_first_name": "JAYNIE",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "262-657-8434"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• L Carr and Company
• Alexandre Lacrosse
• Anne R Lakayil, DDS
• Lakeshore Pain and Spine Center LLC
• Lakeshores Outpatient Clinic
• Lakeside Family Practice
• Jevan Christopher Lalgee, HIS
• Pamela A. Lamacchia, CSAC
• Kristine Marie Lamothe, LPN
• Jessica Lancaster, MD

• All providers in Kenosha, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.