Lakeside Urology PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

LAKESIDE UROLOGY PC

Practice address

815 Saint Joseph Dr
Saint Joseph, MI 49085-2529

Phone

(269) 982-4272

Fax

(269) 983-5920

NPI assigned

Aug 17, 2006

Organization subpart

No

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

Authorized official

Name

Peter Bridges, MD

Title

Physician/Office Manager

Phone

(269) 982-4272

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• David W Terhune, M.D.

  • Urology Physician
  • Saint Joseph, MI
  • NPI 1639157308
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1770696171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 SAINT JOSEPH DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852529",
            "telephone_number": "269-982-4272",
            "fax_number": "269-983-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 SAINT JOSEPH DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852529",
            "telephone_number": "269-982-4272",
            "fax_number": "269-983-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE UROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PHYSICIAN/OFFICE MANAGER",
        "authorized_official_telephone_number": "269-982-4272",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "0A11030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeshore Anesthesia Staffing LLC
• Lakeside Cancer Specialists, PLLC
• Lakeside Diabetes & Endocrine Center PLLC
• Lakeside Healthcare Specialists PLLC
• Lakeside Pulmonary Medicine PLLC
• Kara Lampinen, CCC-SLP
• William Lon Peterson Lancaster, PA-C
• Isabella Assunta Lane, DO
• Paige Elizabeth Lanham, LLMSW
• Bruce L Larva, M.D.

• Urology Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.