Lakeshore Spine and Pain PC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

LAKESHORE SPINE AND PAIN PC

Practice address

5511 W US Highway 10
Suite B
Ludington, MI 49431-2455

Phone

(231) 843-1553

NPI assigned

Dec 9, 2011

Organization subpart

No

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

Authorized official

Name

Raj Makwana

Title

Administrator

Phone

(231) 843-1553

Specialties & licenses 1

Addresses

Other names 1

• Accessible Urgent Care Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Practitioners 7

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

• Abid H Agha, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Reed City, MI
  • NPI 1831125467
  NPD (past)
• Krupal R Amin, RPT

  • Physical Therapist
  • North Muskegon, MI
  • NPI 1275868879
  NPD (past)
• Deval Achal Patel, RPT

  • Physical Therapist
  • Reed City, MI
  • NPI 1013194687
  NPD (past)
• Dipa B. Patel, RPT

  • Physical Therapist
  • Ludington, MI
  • NPI 1134455785
  NPD (past)
• Prashanti Bishan Sarup Saxena, RPT

  • Physical Therapist
  • Montague, MI
  • NPI 1083892921
  NPD (past)
• Vivek Thakore, BS MS RPT

  • Physical Therapy Clinic/Center
  • Ludington, MI
  • NPI 1609986405
  NPD (past)
• Santoshkumar D Gandhi, RPT

  • Physical Therapist
  • High Point, NC
  • NPI 1649374836
  NPD (past)

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1699043299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 W US HIGHWAY 10",
            "address_2": "SUITE B",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5511 W US HIGHWAY 10",
            "address_2": "SUITE B",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312455",
            "telephone_number": "231-843-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE SPINE AND PAIN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "MAKWANA",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "231-843-1553"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Accessible Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carol Ann Kubanek-Erdman, R.N.
• Sarah Kucera
• Nathaniel Thomas Ladaga, DO
• Lakeshore Regional Entity
• Lakeshore Spine and Pain P C
• Lakeshore Vein &Laser Clinic PLLC
• Lakewinds Dental Centre
• Britney Laman, LMSW
• Jaime Lynn Lamendola, RN
• Amanda L Lang, O.D.

• Rural Health Clinic/Center in Ludington, MI
• Providers in Ludington, MI by specialty
• Rural Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.