LAKESHORE MEDICAL CLINIC (NPI# 1861754244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861754244 |
| Entity Type | Organization |
| Organization Name | LAKESHORE MEDICAL CLINIC |
| Practice Address |
4444 West Loomis Road 200 Greenfield WI 53220 |
| Mailing Address |
100 15th Ave South Milwaukee WI 53172-1160 |
| Practice Telephone | 4142815150 |
| Mailing Telephone | 4147643241 |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |
| Authorized Official Name | MASOOD WASIULLAH (PRESIDENT) |
| Authorized Official Telephone | 4145252433 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
Ambulatory Health Care Facilities | ||
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205240686 | Lakeshore Medical Clinic | Nurse Practitioner | 3305 S 20th St, Suite 100, Milwaukee, WI 53215-4940 | 2014-06-13 |
| 1053748160 | Lakeshore Medical Clinic | Nurse Practitioner | 100 15th Ave, South Milwaukee, WI 53172-1160 | 2013-10-03 |
| 1629206230 | Lakeshore Medical Clinic | Durable Medical Equipment & Medical Supplies | 10520 N Port Washington Rd, Mequon, WI 53092-5537 | 2009-06-23 |
| Street Address |
4444 WEST LOOMIS ROAD 200 |
| City | GREENFIELD |
| State | WI |
| Zip Code | 53220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871061069 | Kathleen Elizabeth White | Orthotist | 6790 W. Layton Ave, Greenfield, WI 53220 | 2018-11-06 |
| 1992284087 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 4859 South 60th Street, Greenfield, WI 53220 | 2018-08-09 |
| 1609394220 | Aaron Park | Speech-Language Pathologist | 3540 S. 43rd St., Milwaukee, WI 53220 | 2017-09-04 |
| 1730601675 | Rosaana Avila | Physical Therapist | 3944 S. 60th St., Milwaukee, WI 53220 | 2017-07-12 |
| 1285002667 | Casey E Reis | Nurse Practitioner | 4848 S. 76th Street, Greenfield, WI 53220 | 2015-09-02 |
| 1437539798 | Luke Robert Garceau | Physical Therapist | 6520 W. Layton Ave #101, Greenfield, WI 53220 | 2015-06-02 |
| 1295139012 | Tammy Giannopoulos, LLC | Clinic/Center | 4402 S 68th St Suite 100, Greenfield, WI 53220 | 2014-10-22 |
| 1598083115 | Rebecca Anne Kappes | Licensed Practical Nurse | 8208 W Tripoli, Milwaukee, WI 53220 | 2010-05-06 |
| 1699941005 | Susan Marie Delaet | Physical Therapy Assistant | 5700 West Layton Ave, Greenfield, WI 53220 | 2008-05-06 |
| 1962680876 | Donald Joseph Lewandowski | Dentist | 4915 S 79 St, Greenfield, WI 53220 | 2008-02-01 |
| Find all providers in zip 53220 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598935967 | Foundation Physical Therapy LLC | Clinic/Center | 5335 S Hidden Dr, Greenfield, WI 53221-3241 | 2008-03-02 |
| 1407985542 | Occupational Health Centers of The Southwest, P.a., Co. | Clinic/Center | 489 Bernardston Rd., Greenfield, MA 01301 | 2007-03-05 |
| 1043255409 | Preferred Rehabilitation and Orthopedic Care Center S.c. | Clinic/Center | 6520 W Layton Ave, Greenfield, WI 53220-4523 | 2006-06-19 |
| 1447250006 | Rehabclinics Galaxy Inc | Clinic/Center | 4600 W Loomis Rd, Suite 120, Greenfield, WI 53220-4858 | 2005-07-26 |
| 1255604427 | Greenfield Rehabilitation Agency | Clinic/Center | 7517 W Coldspring Rd, Greenfield, WI 53220-2814 | 2012-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093313074 | Byond Physical Therapy, LLC | Clinic/Center | 11320 W Forest Home Ave, Franklin, WI 53132-1401 | 2020-10-13 |
| 1568078780 | Streamline Physical Therapy | Clinic/Center | 5806 Crabapple Ln, Madison, WI 53711-3437 | 2020-09-22 |
| 1790311199 | Exos Wi LLC | Clinic/Center | 7044 S Ballpark Dr Ste 300, Franklin, WI 53132-6910 | 2020-03-17 |
| 1831735885 | Garvey Physical Therapy & Wellness LLC | Clinic/Center | 417 Maple Ct, Campbellsport, WI 53010-3531 | 2019-11-25 |
| 1821649088 | Impact Physical Therapy & Performance LLC | Clinic/Center | 1155 Clarity Dr, Verona, WI 53593-9318 | 2019-09-27 |
| 1427605146 | Peak Endurance | Clinic/Center | 15 N Butler St, Madison, WI 53703-4237 | 2019-08-19 |
| 1558917617 | Quad/med, LLC | Clinic/Center | N61 W23044 Harry's Way, Sussex, WI 53089 | 2019-08-14 |
| 1619521267 | Space To Be Well, LLC | Clinic/Center | 1091 Sutherland Ave, River Falls, WI 54022-7509 | 2019-07-31 |
| 1346894656 | Cornerstone Physical Therapy, LLC | Clinic/Center | 2829 County Highway I Ste 3, Chippewa Falls, WI 54729-2678 | 2019-07-25 |
| 1619437514 | Resilience Rx LLC | Clinic/Center | 4708 Graywood Ct Apt 3, Nashotah, WI 53058-9688 | 2019-03-25 |
| Find all providers with the same taxonomy | ||||
| City | GREENFIELD |
| Zip Code | 53220 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.