NPIMap

Organization Active NPI

Lakeview Health, LLC

  • Multi-Specialty Clinic/Center
  • Racine, WI
National Provider Identifier
1679254700
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LAKEVIEW HEALTH, LLC
Practice address
800 Goold St
Racine, WI 53402-4567
Phone
(262) 456-2182
Fax
(262) 456-2457
NPI assigned
Jul 31, 2023
Last updated
Jul 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Glen Bordak, MDNPI 1588683718
Title
Owner
Phone
(262) 498-0432

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

800 Goold St
Racine, WI 53402-4567

Mailing address

800 Goold St
Racine, WI 53402-4567
Phone (262) 456-2182

National Provider Directory

National Provider Directory

Locations

800 Goold St
Racine, WI 53402
Phone (262) 456-2182

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1679254700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GOOLD ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534024567",
            "telephone_number": "262-456-2182",
            "fax_number": "262-456-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GOOLD ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534024567",
            "telephone_number": "262-456-2182",
            "fax_number": "262-456-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "BORDAK",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-498-0432",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.