Lakeview Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02001252 Issued in IN

Legal business name

LAKEVIEW FAMILY MEDICINE, LLC

Practice address

204W Main St
Arcadia, IN 46030

Phone

(317) 984-8811

Fax

(317) 984-5862

NPI assigned

Dec 7, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Glen E Leer, D.O.NPI 1063505667

Title

Owner

Phone

(317) 984-8811

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

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.

• Glen E Leer, D.O.

  • Family Medicine Physician
  • Arcadia, IN
  • NPI 1063505667

  Family Medicine, IN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260144000000",
    "number": "1811226640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 383",
            "city": "ARCADIA",
            "state": "IN",
            "postal_code": "460300383",
            "telephone_number": "317-984-8811",
            "fax_number": "317-984-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204W MAIN ST",
            "city": "ARCADIA",
            "state": "IN",
            "postal_code": "46030",
            "telephone_number": "317-984-8811",
            "fax_number": "317-984-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2009-12-07",
        "status": "A",
        "authorized_official_last_name": "LEER",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-984-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Glen E Leer, D.O.
• New Age Healthcare LLC
• Jacquelyn Nordmann
• Gale Lynn Seal, M.A., CCC/SLP
• Allison Snyder

• All providers in Arcadia, IN
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.