LAKESIDE FAMILY PRACTICE
LAKESIDE FAMILY PRACTICE is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1831698430, based in Kenosha, WI. The organization lists 2 taxonomy classifications, with Family Nurse Practitioner recorded as primary.
Getting there
The practice address on file is 3200 SHERIDAN RD STE 104, Kenosha, WI 53140. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 2011006054 | WI | Family Nurse Practitioner primary |
| 6190-33 | WI | Gerontology Nurse Practitioner |
This provider holds licence 2011006054 issued in WI. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Family covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363LF0000X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363LF0000X | Family Nurse Practitioner Family | 2011006054 | WI | primary |
| 363LG0600X | Gerontology Nurse Practitioner Gerontology | 6190-33 | WI |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1831698430 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Feb 8, 2018 |
| Last updated | Feb 8, 2018 |
| Status | Active |
| Practice address |
3200 SHERIDAN RD STE 104 Kenosha, WI 53140 (262) 225-1014 |
| Mailing address |
2113 TALLGRASS CIR Waukesha, WI 53188 |
| Other identifiers |
100043522
· Medicaid (WI) 100018824 · Medicaid (WI) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 8 | 3 | 1 | 6 | 9 | 8 | 4 | 3 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 8 | 6 | 1 | 3 | 9 | 7 | 4 | 6 |
Sum = 70 · next multiple of 10 = 70 · check digit = 0 · actual last digit = 0
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.