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Lake Avenue Eyecare LLC

Eyewear Supplier in Gothenburg, NE · enumerated 2007 · authorized official John Gosnell, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1396932430

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Registry record

Entity type Organization (Type 2)
Legal business name Lake Avenue Eyecare LLC
Practice address 829 Lake Ave, Gothenburg, NE, 69138
Phone (308) 537-3390
Fax (308) 537-3391
Enumeration date Oct 3, 2007
Last updated in NPPES Oct 27, 2022

Taxonomy & classification

152W00000X Optometrist Eye and Vision Services Providers · License 1166 (NE) Secondary
332H00000X Eyewear Supplier Suppliers · License 1166 (NE) Primary

Authorized official

Name John Gosnell
Title Owner
Phone (308) 537-3390

Other identifiers

Identifier Type State Issuer
240481 Other - MIDLANDS CHOICE
06754 Other - BLUE CROSS BLUE SHIELDPIN
10024987700 Medicaid NE -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Lake Avenue Eyecare LLC?
Lake Avenue Eyecare LLC is registered in NPPES as a Eyewear Supplier (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-10-27.