LAKESIDE ORTHOPEDIC INSTITUTE, LLC (NPI# 1912524380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912524380 |
| Entity Type | Organization |
| Organization Name | LAKESIDE ORTHOPEDIC INSTITUTE, LLC |
| Practice Address |
25 Riviera Blvd Lake Havasu City AZ 86403-5694 |
| Practice Telephone | 9285055555 |
| Practice Fax Number | 9285052877 |
| Mailing Telephone | 9285055555 |
| Mailing Fax Number | 9285052877 |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-07-01 |
| Authorized Official Name | DANIEL EDWARD HEINER (PARTNER) |
| Authorized Official Telephone | 9285055555 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902137417 | Lakeside Orthopedic Institute, LLC | Orthopaedic Surgery | 150 East Tyson Rd, Quartzsite, AZ 85359 | 2010-01-22 |
| 1023349511 | Lakeside Orthopedic Institute, LLC | Orthopaedic Surgery | 1016 S Joshua Ave., Parker, AZ 85344-5027 | 2010-01-22 |
| 1962636050 | Lakeside Orthopedic Institute, LLC | Physical Therapist | 1979 Mcculloch Blvd N, Suite 101, Lake Havasu City, AZ 86403-0953 | 2009-05-05 |
| Street Address |
25 RIVIERA BLVD |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-5694 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205813565 | Ronald Bernard Killian | Podiatrist | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2005-12-28 |
| 1083265573 | Anita Gail Martin | Physical Therapist | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2019-09-25 |
| 1154780633 | Lakeside Physical Therapy, Rehab & Sports Medicine | Specialist/Technologist | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2016-02-12 |
| 1679764229 | Lakeside Orthopedic Institute LLC | Orthopaedic Surgery | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2007-08-08 |
| 1093938128 | Janet Marie Marinelli | Physician Assistant | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2007-04-10 |
| 1043245293 | William F Binder | Orthopaedic Surgery | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2006-07-12 |
| 1558331181 | Derek M Burnett | Physical Medicine & Rehabilitation | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2006-01-25 |
| 1841270873 | Daniel Edward Heiner | Orthopaedic Surgery | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2006-01-17 |
| 1649265596 | Eung Jun Cha | Orthopaedic Surgery | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2005-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003113010 | Arizona Coast Wide Open Mri, Pllc | Clinic/Center | 2130 Mesquite Ave, Suite 108, Lake Havasu City, AZ 86403-6897 | 2011-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522236 | Advanced Injury Care | Clinic/Center | 9820 E Thompson Peak Pkwy Unit 715, Scottsdale, AZ 85255-6657 | 2018-09-18 |
| 1730619289 | Injury Imaging Solutions LLC | Clinic/Center | 1345 E Mckellips Rd Ste 103, Mesa, AZ 85203-2721 | 2017-06-18 |
| 1356650105 | Desert Mri Lab LLC | Clinic/Center | 7340 E Calle Meridan, Tuscon, AZ 85710 | 2010-09-28 |
| 1982919411 | Alliance Healthcare Services Inc | Clinic/Center | 4520 E Grant Rd Ste 100, Tucson, AZ 85712-2637 | 2010-08-09 |
| 1356506240 | Insight Health Corp | Clinic/Center | 5040 N. 15th Ave, Suite 101, Phoenix, AZ 85015 | 2008-07-21 |
| 1003094830 | Silver Creek Mri LLC | Clinic/Center | 1245 Hancock Rd, Suite B, Bullhead City, AZ 86442-5940 | 2008-02-04 |
| 1457495095 | Arizona Community Physicians PC | Clinic/Center | 2191 W Orange Grove Rd, Tucson, AZ 85741-3118 | 2007-02-16 |
| 1922141902 | Arizona Community Physician PC | Clinic/Center | 6270 E Grant Rd, Tucson, AZ 85712-5831 | 2007-02-15 |
| 1730132036 | Northwest Rancho Vistoso Imaging Services LLC | Clinic/Center | 1845 W Orange Grove, Tucson, AZ 85741 | 2006-05-18 |
| 1730726365 | Arista Imaging, LLC | Clinic/Center | 3139 E Lincoln Dr, Phoenix, AZ 85016 | 2019-12-02 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
Please comment or provide details below to improve the information on LAKESIDE ORTHOPEDIC INSTITUTE, LLC.
| 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.