OrganizationActive
Lakeshore Interventional Treatment Center LLC
NPI 1043701543 · Pain Clinic/Center · Tempe, AZ
Provider details
- NPI number
- 1043701543
- Entity type
- Organization
- Primary specialty
- Pain Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Shawn Vigneau, Member(480) 556-9755
Specialties & taxonomies
Ambulatory Health Care Facilities
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
- Ambulatory Surgical Clinic/Center261QA1903X
Ambulatory Health Care Facilities
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4765 S Lakeshore Dr
Tempe, AZ 85282
Phone: (480) 566-9755
Street-level locationGet directions
Mailing address
4765 S Lakeshore Dr
Tempe, AZ 85282-7197
Registry dates
- Enumerated
- 2018-05-21
- Last updated
- 2019-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.