Lakeside Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100067 Issued in ID

Legal business name

LAKESIDE EYECARE

Practice address

312 N 4TH St
Coeur D Alene, ID 83814-2812

Phone

(208) 676-1422

Fax

(208) 667-7730

NPI assigned

Apr 15, 2009

Last updated

Feb 5, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Lloyd Calderwood, O.D.

Title

Owner

Phone

(208) 676-1422

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, and the practitioner matching its NPPES authorized official.

• Rupert C Chowins, O.D.

  • Optometrist
  • San Luis Obispo, CA
  • NPI 1750368304
  NPD (past)

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265328000000",
    "number": "1881837243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 N 4TH ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142812",
            "telephone_number": "208-676-1422",
            "fax_number": "208-667-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 N 4TH ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142812",
            "telephone_number": "208-676-1422",
            "fax_number": "208-667-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2010-02-05",
        "status": "A",
        "authorized_official_last_name": "CALDERWOOD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-676-1422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807139300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake City Dental Specialties, PC
• Lake City Medical Investors, LLC (Life Care Center of Coeur D'Alene)
• Lake City Physical Therapy P a
• Lake City Shoe Repair
• Lake City Surgeons PLLC
• Lakeside Holistic Health, PLLC
• Lakeside Pediatric & Adolescent Medicine, PLLC
• Lakeview Dental
• Lakewood Physical Therapy LLC
• Jared Lambert

• Optometrist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.