Lake Mi Mobile Doctors, P.C.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

LAKE MI MOBILE DOCTORS, P.C.

Practice address

3388 Founders Rd
Suite C
Indianapolis, IN 46268-1443

Phone

(317) 471-8701

Fax

(317) 471-8702

NPI assigned

May 12, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Tysyn Contreras

Title

Director, Quality Assurance

Phone

(773) 751-7200

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mobile Doctors of Indianapolis Doing business as

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1740457555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185811",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3388 FOUNDERS RD",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681443",
            "telephone_number": "317-471-8701",
            "fax_number": "317-471-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MI MOBILE DOCTORS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "TYSYN",
        "authorized_official_title_or_position": "DIRECTOR, QUALITY ASSURANCE",
        "authorized_official_telephone_number": "773-751-7200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200946960B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Doctors of Indianapolis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Laird, PA-C
• Gina Elisa Laite, M.D.
• Brian D Lajiness, MD
• Jacquelyn D Lajiness, MD, PHD
• David Lakanen
• Amy Lake, NP
• Jordan Tyler Lakes, MSOT
• Lakeshore Chiropractic PC
• Lakeside Chiropractic Clinic PC
• Lakeview Manor, Inc.

• Geriatric Medicine (Internal Medicine) Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Geriatric Medicine (Internal Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.