Lakeshore Pain and Spine Center LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

LAKESHORE PAIN AND SPINE CENTER LLC

Doing business as

Lakeshore Pain and Spine Center LLC

Practice address

7201 Green Bay Rd
Kenosha, WI 53142-3532

Phone

(312) 519-9936

NPI assigned

Apr 21, 2021

Last updated

Aug 2, 2021By 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

Dr. Bradley Silva, MDNPI 1992123269

Title

Owner/MD

Phone

(262) 484-4035

Specialties & licenses 1

Addresses

Other names 1

• LAKESHORE PAIN AND SPINE CENTER LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Bradley Alan Silva, MD

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1992123269

  Pain Medicine, WI

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1689256539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 GREEN BAY RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423532",
            "telephone_number": "312-519-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE PAIN AND SPINE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "SILVA",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "262-484-4035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKESHORE PAIN AND SPINE CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LAKESHORE PAIN AND SPINE CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vickie L Kutzler, SA-C
• L & M Transport LLC
• L Carr and Company
• Alexandre Lacrosse
• Anne R Lakayil, DDS
• Lakeshores Outpatient Clinic (Brotoloc)
• Lakeside Chiropractic LLC
• Lakeside Family Practice
• Jevan Christopher Lalgee, HIS
• Pamela A. Lamacchia, CSAC

• Pain Medicine (Anesthesiology) Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Pain Medicine (Anesthesiology) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.