Lakeside Orthopedics, PC.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

LAKESIDE ORTHOPEDICS, PC.

Practice address

16909 Lakeside Hills CT
Suite 208
Omaha, NE 68130-2318

Phone

(402) 758-5690

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

David Clough, MD

Title

President

Phone

(402) 758-5690

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1861437493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16909 LAKESIDE HILLS CT",
            "address_2": "SUITE 208",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302318",
            "telephone_number": "402-758-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 LAKESIDE HILLS CT",
            "address_2": "SUITE 208",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302318",
            "telephone_number": "402-758-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE ORTHOPEDICS, PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "CLOUGH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-758-5690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF1449",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0733162",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025437200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeside Ambulatory Surgical Center LLC
• Lakeside Chiropractic Specialists
• Lakeside Ear, Nose, & Throat Physicians, PC
• Lakeside Endoscopy Center LLC
• Lakeside Orthopedics PC
• Brock Lakin
• Savannah Lakin
• Lakota Lodge Counseling Clinic, LLC
• Esther Lali Tchegninougbo
• Tanner Lalich

• Orthopaedic Surgery Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Orthopaedic Surgery Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; 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.