LAKES ORTHOPAEDIC SPECIALISTS P.A. (NPI# 1336259746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336259746 |
| Entity Type | Organization |
| Organization Name | LAKES ORTHOPAEDIC SPECIALISTS P.A. |
| Practice Address |
5200 Fairview Blvd Wyoming MN 55092-8013 |
| Practice Telephone | 6513890185 |
| Practice Fax Number | 6519827677 |
| Mailing Telephone | 6513890185 |
| Mailing Fax Number | 6519827677 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SHERRIE A HOULE (MEDICAL SECTRETARY) |
| Authorized Official Telephone | 6513890185 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ========= | MN | Other Service Providers |
| Street Address |
5200 FAIRVIEW BLVD |
| City | WYOMING |
| State | MN |
| Zip Code | 55092-8013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061371 | Gunnar Jon Erickson | Ophthalmology | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2005-05-24 |
| 1902414378 | Fairview Express Care | General Practice | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-07-21 |
| 1023648235 | Cassandra L Etheridge | Physician Assistant | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-01-16 |
| 1023652211 | Natasha Lackas | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-10-31 |
| 1467019414 | Terrence Ellis | Clinical Exercise Physiologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-24 |
| 1790341493 | Krystal Kraemer | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-17 |
| 1225509037 | Lauren Downie | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-12-06 |
| 1861977787 | Magdalen Rene Gadbois | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-09-26 |
| 1285110338 | Marie Hudalla | Physical Therapist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-07-12 |
| 1023502697 | Molly Levy | Nurse Practitioner | 5200 Fairview Blvd, Wyoming, MN 55092 | 2018-06-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1851909436 | Matthew Rohlf | Dentist | 5378 E Viking Blvd, Wyoming, MN 55092 | 2020-07-20 |
| 1669013280 | Christina Marie Orde | Technician | 4855 261st Street, Wyoming, MN 55092 | 2019-10-04 |
| 1609425966 | Faith Bouttell | Technician | 25423 Heims Lake Circle, Wyoming, MN 55092 | 2019-09-10 |
| 1275875031 | Fairview Express Care | Clinic/Center | 5130 Fairview Blvd, Suite 101, Wyoming, MN 55092 | 2013-03-20 |
| 1023385242 | St. Croix Orthopaedics, P.a. | Durable Medical Equipment & Medical Supplies | 5200 Fairview Blvd., Wyoming, MN 55092 | 2011-11-17 |
| 1902851876 | Tamara Piroska Petrac-halatsis | Obstetrics & Gynecology | 5200 Fairview Boulevard, Ob/gyn Department, Wyoming, MN 55092 | 2006-05-22 |
| 1376922070 | Carli Lynn Ceder | Physical Therapist | 5130 Fairview Blvd, Wyoming, MN 55092 | 2015-05-27 |
| 1396087433 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 5130 Fairview Blvd, Suite 104, Wyoming, MN 55092 | 2013-03-26 |
| 1598007726 | Fairview Health Services | Prosthetic/Orthotic Supplier | 5130 Fairview Blvd, Suite 103, Wyoming, MN 55092 | 2013-03-26 |
| Find all providers in zip 55092 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891988499 | Rebecca Lynn Sing | Specialist | 2121 Cypress St Sw, Wyoming, MI 49519-3614 | 2007-08-27 |
| 1043358187 | Washington County Physical Therapy | Specialist | 12 Stilson Rd, Wyoming, RI 02898-0064 | 2007-02-01 |
| 1992884332 | Buenaventura Carmen Pereyra | Specialist | 4433 Byron Center Ave Sw, Pediatrics Primary Care, Wyoming, MI 49519-4844 | 2006-11-05 |
| 1982694667 | Renee J Elderkin | Specialist | 2221 Health Dr Sw Ste 2100, Wyoming, MI 49519-9650 | 2005-10-25 |
| 1952301038 | Larry Jose Diaz | Specialist | 2122 Health Dr Sw, Wyoming, MI 49519-9698 | 2005-07-29 |
| 1346587805 | Fairview Express Care | Specialist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2013-01-03 |
| 1609896034 | Jack A Dekkinga Md PC | Specialist | 2660 44th St Sw Ste 100, Wyoming, MI 49519-6836 | 2006-07-20 |
| 1639123235 | Yasmeen Ahmad | Specialist | 2122 Health Dr Sw, Wyoming, MI 49519-9698 | 2006-05-19 |
| 1043201551 | Susan K Hicks | Specialist | 2221 Health Dr Sw Ste 2100, Wyoming, MI 49519 | 2005-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245846369 | Cyprian O Marubi | Specialist | 2021 E Hennepin Ave Ste 402, Minneapolis, MN 55413-1867 | 2020-09-23 |
| 1992327415 | Julie Baker | Specialist | 907 W Central Entrance, Duluth, MN 55811-5469 | 2020-05-07 |
| 1710521257 | Karly Bauer | Specialist | 512 30th Ave E Ste 10, Alexandria, MN 56308-5096 | 2019-10-28 |
| 1447816632 | Advanced Brain and Body Clinic Pllc | Specialist | 126 N 3rd St Ste 402, Minneapolis, MN 55401-2838 | 2019-05-14 |
| 1184181349 | Beverly Teresa Brending | Specialist | 745 Grand Ave Ste 101, Saint Paul, MN 55105-3384 | 2019-02-25 |
| 1982190294 | Lori Hunt | Specialist | 6425 Flying Cloud Dr, Eden Prairie, MN 55344-4555 | 2018-07-10 |
| 1346769692 | Darci Stanford | Specialist | 130 E Vine St, Owatonna, MN 55060-2428 | 2017-09-18 |
| 1407397250 | Malcolm Watt | Specialist | 7 Cannon St W, Dundas, MN 55019-4039 | 2017-03-13 |
| 1821532284 | Diana Mason | Specialist | 8170 Hillcrest Dr Ne, Bemidji, MN 56601-8993 | 2016-12-05 |
| 1649726910 | Rebecca Hoffman Pllc | Specialist | 3400 1st Street N, Suite 300, St. Cloud, MN 56301 | 2016-08-28 |
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| 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.