Lakeshore Healthcare Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LAKESHORE HEALTHCARE SERVICES, INC.

Practice address

9550 Forest LN
Suite 102
Dallas, TX 75243-5905

Phone

(214) 348-9700

Fax

(214) 348-9701

NPI assigned

Jun 16, 2008

Organization subpart

No

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

Authorized official

Name

Anthony E Nwedo

Title

President

Phone

(214) 348-9700

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801056460. Details of each certification follow.

• CCN 747320 Home health agency · Active · Details

Home health agency certification: CCN 747320

Legal name

LAKESHORE HEALTHCARE SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 17, 2010

Last certification

Dec 20, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

May 21, 2008 in TX

Enrollment address

126 N International Rd
Ste B
Garland, TX 75042-6515

Listed as

Lakeshore Healthcare Services IncCCN 747320 · All quality measures

Ownership

Proprietary

Certified

Mar 17, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1801056460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 FOREST LN",
            "address_2": "SUITE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435905",
            "telephone_number": "214-348-9700",
            "fax_number": "214-348-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 FOREST LN",
            "address_2": "SUITE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435905",
            "telephone_number": "214-348-9700",
            "fax_number": "214-348-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "NWEDO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-348-9700"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lake
• Kimberly J Lake, DDS
• Lakehill Preparatory School: Health and Wellness Center
• Lakeshia Kijuan Ealy (Gentle Hands Home Health Care)
• Lakeshore Anesthesia Group, PLLC
• Lakeshore Medical Supplies, Inc.
• Lakeview ENT, PA
• Lakeview Health Solutions, PLLC
• Lakeview Primary Homecare LLC
• Lakewood Anesthesia, PLLC

• Home Health Agency in Dallas, TX
• Providers in Dallas, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.