MAYO CLINIC HEALTH SYSTEM-LAKE CITY (NPI# 1164463659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164463659 |
| Entity Type | Organization |
| Organization Name | MAYO CLINIC HEALTH SYSTEM-LAKE CITY |
| Practice Address |
500 W Grant St Lake City MN 55041-1143 |
| Practice Telephone | 6513453321 |
| Mailing Telephone | 6513453321 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2017-12-29 |
| Authorized Official Name | CHARLOTTE NORDRUM (CFO) |
| Authorized Official Telephone | 5075381446 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
MN | Ambulatory Health Care Facilities | |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447863972 | Mayo Clinic Health System-lake City | Non-Pharmacy Dispensing Site | 500 W Grant St, Lake City, MN 55041-1143 | 2020-08-25 |
| 1891710893 | Mayo Clinic Health System-lake City | Medicare Defined Swing Bed Unit | 500 W Grant St, Lake City, MN 55041-1143 | 2006-07-12 |
| 1831130319 | Mayo Clinic Health System-lake City | Skilled Nursing Facility | 500 W Grant St, Lake City, MN 55041-1143 | 2006-06-08 |
| 1538113022 | Mayo Clinic Health System-lake City | General Acute Care Hospital | 500 W Grant St, Lake City, MN 55041-1143 | 2006-05-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAYO CLINIC HEALTH SYSTEM-LAKE CITY | 500 West Grant St, Lake City, MN 55041-1143 |
| Street Address |
500 W GRANT ST |
| City | LAKE CITY |
| State | MN |
| Zip Code | 55041-1143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689650350 | Ann Marie Lowe | Family Medicine | 500 W Grant St, Lake City, MN 55041-1143 | 2005-12-15 |
| 1689280406 | Kelly Marie Kennedy | Pharmacist | 500 W Grant St, Lake City, MN 55041-1143 | 2020-09-17 |
| 1447863972 | Mayo Clinic Health System-lake City | Non-Pharmacy Dispensing Site | 500 W Grant St, Lake City, MN 55041-1143 | 2020-08-25 |
| 1124638341 | Rebekah Richter | Physical Therapist | 500 W Grant St, Lake City, MN 55041-1143 | 2020-08-03 |
| 1225661416 | Patricia Elena Servin-hughes | Nurse Practitioner | 500 W Grant St, Lake City, MN 55041-1143 | 2020-02-17 |
| 1598318016 | Shannon Campbell | Physical Therapist | 500 W Grant St, Lake City, MN 55041-1143 | 2019-07-23 |
| 1861965774 | Cole James Kriett | Physician Assistant | 500 W Grant St, Lake City, MN 55041-1143 | 2019-01-03 |
| 1992217673 | Tina Marie Montgomery | Speech-Language Pathologist | 500 W Grant St, Lake City, MN 55041-1143 | 2017-11-02 |
| 1972015923 | Heather Nagel | Physical Therapist | 500 W Grant St, Lake City, MN 55041-1143 | 2017-10-31 |
| 1821500265 | Simone Leanne Lenertz | Occupational Therapist | 500 W Grant St, Lake City, MN 55041-1143 | 2017-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285136242 | Perry Dental, Ltd. | Dentist | 210 N. Lakeshore Dr., Lake City, MN 55041 | 2018-03-06 |
| 1790182335 | Innovative Chiropractic Center | Chiropractor | 201 D East Ave., Red Wing, MN 55041 | 2014-11-25 |
| 1245327147 | David F Valkos | Chiropractor | 106 So Washington St, Lake City, MN 55041 | 2006-10-10 |
| 1063441830 | Michael D Ackermann | Optometrist | 117 W Center St, Lake City, MN 55041 | 2006-07-02 |
| 1760668693 | Elizabeth Agnes Olson | Chiropractor | 106 S Washington St, Lake City, MN 55041-1034 | 2008-01-10 |
| 1194900936 | Valkos Chiropractic Office, LLC | Clinic/Center | 106 S Washington St, Lake City, MN 55041-1034 | 2007-12-28 |
| 1417333428 | River Oaks At Lake Pepin, LLC. | Home Health | 815 N High St, Lake City, MN 55041-1225 | 2015-08-03 |
| 1124189444 | Stephen Lee Brown | Dentist | 1350 N 7th St, Lake City, MN 55041-1251 | 2006-12-12 |
| 1114188307 | Pepin Valley Dental | Clinic/Center | 1350 N 7th St, Lake City, MN 55041-1251 | 2008-06-19 |
| 1366627564 | Lesa Ann Funke | Dental Hygienist | 1350 N 7th St, Lake City, MN 55041-1251 | 2008-01-07 |
| Find all providers in zip 55041 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497854186 | Shands At Lake Shore Inc | Clinic/Center | 348 Ne Methodist Ter, Suite 101, Lake City, FL 32055-3409 | 2006-09-21 |
| 1437692407 | Prime Care of The Lower Pee Dee, LLC | Clinic/Center | 263 Kelley St Ste 100, Lake City, SC 29560-2472 | 2016-11-23 |
| 1871692475 | Shands At Lake Shore Inc | Clinic/Center | 755 Sw State Road 47, Lake City, FL 32025-0453 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855162 | The Duluth Clinic Ltd | Clinic/Center | 1600 Miller Trunk Hwy Ste 1300, Duluth, MN 55811-5640 | 2020-06-16 |
| 1184250060 | Premise Health of Minnesota Medical P C | Clinic/Center | 1906 8th St Nw, Austin, MN 55912-2473 | 2020-03-23 |
| 1053952606 | Fairview Express Care | Clinic/Center | 2512 6th Street, Suite F105, Minneapolis, MN 55454-1401 | 2019-10-04 |
| 1730731464 | St Marys Regional Health Center | Clinic/Center | 1103 1st St E, Park Rapids, MN 56470 | 2019-07-12 |
| 1003478892 | The Duluth Clinic Ltd | Clinic/Center | 4289 Ugstad Rd, Hermantown, MN 55811-3615 | 2019-07-02 |
| 1073005856 | Arbor Integrative Behavioral Health | Clinic/Center | 1000 E 1st St Ste 105, Duluth, MN 55805-2297 | 2018-06-06 |
| 1689161077 | Chs Tennessee Medical P C | Clinic/Center | 701 Brooks Ave S, Thief River Falls, MN 56701-2757 | 2018-04-20 |
| 1427557867 | Gillette Children's Specialty Healthcare | Clinic/Center | 505 Paul Bunyan Dr Nw, Bemidji, MN 56601-2400 | 2018-02-11 |
| 1992224331 | Orthopedic & Sports Physical Therapy, Inc. | Clinic/Center | 322 N Tower Rd, Fergus Falls, MN 56537-1015 | 2017-09-18 |
| 1003339789 | Centracare Clinic | Clinic/Center | 2025 Stearns Way Ste 114, Saint Cloud, MN 56303 | 2017-07-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MAYO CLINIC HEALTH SYSTEM-LAKE CITY.
| 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.