JOHN RICHARD LAKE (NPI# 1740360619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740360619 |
| Entity Type | Individual |
| Full Name | JOHN RICHARD LAKE |
| Credential | MD |
| Practice Address |
University of Minnesota Physicians 516 Delaware Street Se, Clinic 2a Minneapolis MN 55454-1478 |
| Mailing Address |
University of Minnesota Physicians 420 Delaware St Se, Mmc 36 Minneapolis MN 55455 |
| Practice Telephone | 6126266100 |
| Mailing Telephone | 6126266100 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2012-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
40739 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | FAIRVIEW | 114843 | 01 |
| MN | MEDICA-CHOICE | 2900020 | 01 |
| MN | BCBS | 03G121LA | 01 |
| ARAZ | 784417 | 01 | |
| MN | HEALTH PARTNERS | HP28838 | 01 |
| MN | PREFERRED ONE | 1017135 | 01 |
| IA | 0506741 | 05 | |
| MN | MEDICA-PRIMARY | 29-00011 | 01 |
| MN | UCARE | 124409 | 01 |
| WI | 32420100 | 05 | |
| MN | 480019200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629270194 | John T Lake | Psychiatry & Neurology | 60 Doctors Park Lowr Level, Cape Girardeau, MO 63703 | 2007-06-05 |
| 1619081031 | John F Lake | Dentist | 286 Sw 4th St, Ontario, OR 97914-2610 | 2006-08-19 |
| 1952326027 | John Roger Lake Jr. | Dentist | 1322 Main St, Osterville, MA 02655-1542 | 2006-07-12 |
| 1215263017 | John Campbell Lake Jr. | Dentist | 2706 Main St, Newberry, SC 29108-4004 | 2009-10-29 |
| 1861561367 | John M Lake | Counselor | 165 E Hawthorne Ave, Colville, WA 99114-2629 | 2006-11-07 |
| 1871607739 | John Steven Lake | Dentist | 345 Tachevah Dr, Ste 1, Palm Springs, CA 92262 | 2006-08-18 |
| 1780798645 | John Herbert Lake | Dentist | 345 Tachevah Dr, Suite 1, Palm Springs, CA 92262 | 2006-08-18 |
| 1568497238 | John Russell Lake | Orthopaedic Surgery | 5565 Grossmont Center Dr, Bldg 3 Suite 256, La Mesa, CA 91942-3020 | 2006-07-11 |
| Street Address |
UNIVERSITY OF MINNESOTA PHYSICIANS 516 DELAWARE STREET SE, CLINIC 2A |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55454-1478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679528830 | Sarah A Cooley | Internal Medicine | University of Minnesota Physicians, 420 Delaware St Se, Mmc 136, Minneapolis, MN 55455 | 2006-05-24 |
| 1659877181 | Massimo Griselli | Pediatrics | University of Minnesota Physicians, 500 Harvard Street Se, Minneapolis, MN 55455-0363 | 2018-04-03 |
| 1902201221 | Seena Susan George | Nurse Practitioner | University of Minnesota Physicians, Clinics and Surgery Center, 909 Fulton Street Se, Minneapolis, MN 55455 | 2014-10-29 |
| 1508087511 | Tereza Marta Cervenka | Internal Medicine | University of Minnesota Physicians, 516 Delaware St Se, Clinic 2a, Minneapolis, MN 55455 | 2007-05-01 |
| 1346469970 | Stuart Trent Guthrie | Orthopaedic Surgery | University of Minnesota Physicians, 2512 South 7th St, Suite R102, Minneapolis, MN 55454 | 2007-04-24 |
| 1376668251 | Donavon John Hess | Surgery | University of Minnesota Physicians, 516 Delaware St Se, Room 4-100, Minneapolis, MN 55455 | 2007-03-20 |
| 1891836607 | Leon D Sabath | Internal Medicine | University of Minnesota Physicians, 516 Delaware Street Se Clinic 6b, Minneapolis, MN 55455 | 2007-02-12 |
| 1508907882 | Melanie Jean Hanlon | Nurse Practitioner | University of Minnesota Physicians, 516 Delaware St Se 4-100 Pwb, Clinic 4a, Minneapolis, MN 55455 | 2007-02-09 |
| 1912054214 | Muhammad Fareed Khan Suri | Psychiatry & Neurology | University of Minnesota Physicians, 516 Delaware St Se, Clinic 1a, Minneapolis, MN 55455 | 2007-01-05 |
| 1356404503 | Sue V Petzel | Psychologist | University of Minnesota Physicians, 606 24th Ave S, Suite 300, Minneapolis, MN 55455-5545 | 2006-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341842 | Bruce Zhang | Student in an Organized Health Care Education/Training Program | 606 24th Ave. S. Suite 200, Minneapolis, MN 55454 | 2020-06-18 |
| 1205456738 | Sara Segner | Student in an Organized Health Care Education/Training Program | Peds Education Office M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-24 |
| 1417576844 | Sabena Khan | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building. 2450 Riverside Avenue, Minneapolis, MN 55454 | 2020-04-15 |
| 1811525983 | Kayla Joy Solstad | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Bldg., 2450 Riverside Ave, Minneapolis, MN 55454 | 2020-04-01 |
| 1720647126 | Lauren Harasymiw | Student in an Organized Health Care Education/Training Program | Pediatrics Ed. Office, M136, 1st Floor, East Building, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-06-10 |
| 1689237448 | Katelyn Marie Adams | Student in an Organized Health Care Education/Training Program | Pediatrics Education Office, M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-17 |
| 1285197848 | Adrienne Bruder | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building, 8950a, 2450 Riverside Ave, Minneapolis, MN 55454 | 2019-04-10 |
| 1588142855 | Stewart Graeme Morrison | Student in an Organized Health Care Education/Training Program | Department of Orthopaedics University of Minnesota, 2450 Riverside Ave R200, Minneapolis, MN 55454 | 2018-07-30 |
| 1831682251 | Sherab Tsheringla | Student in an Organized Health Care Education/Training Program | 2450 Riverside Avenue South, Minneapolis, MN 55454 | 2018-06-11 |
| 1669962148 | Pooja Elizabeth Mishra | Student in an Organized Health Care Education/Training Program | M136, 1st Floor, East Building 8950a (campus Delivery C, 2450 Riverside Ave, Minneapolis, MN 55454 | 2018-05-10 |
| Find all providers in zip 55454 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457795775 | Tyson Sievers | Internal Medicine | 406 Harvard St Se, Mmc 36, Minneapolis, MN 55455-0362 | 2013-04-18 |
| 1609011949 | Elizabeth Fallon | Internal Medicine | 2550 University Ave West Suite 423 South, Minneapolis, MN 55114-1904 | 2008-12-15 |
| 1598962656 | Maria E Moscandrew | Internal Medicine | 825 S 8th St Ste 250, Minneapolis, MN 55404-1214 | 2007-06-29 |
| 1598960312 | Mustafa A Tiewala | Internal Medicine | 825 S. 8th Street, Suite 250, Minneapolis, MN 55404-1208 | 2007-06-20 |
| 1033127964 | William Charles Duane Jr. | Internal Medicine | 1 Veterans Drive, Gi Section 111d Va Medical Center, Minneapolis, MN 55417-2309 | 2006-08-04 |
| 1194755900 | John J Hughes | Internal Medicine | 2639 Irving Ave S, Minneapolis, MN 55408-1048 | 2006-07-04 |
| 1609804541 | Mngi Digestive Health, P.a. | Internal Medicine | 3001 Broadway St Ne Ste 500, Minneapolis, MN 55413 | 2006-06-29 |
| 1487653564 | Stuart H. Borken | Internal Medicine | 825 South 8th Street, Suite 600, Attn: Parkside Professional Bldg., Minneapolis, MN 55404 | 2005-07-20 |
| 1114289873 | Joshua Sloan | Internal Medicine | 420 Delaware St Se, Minneapolis, MN 55455-0341 | 2012-06-08 |
| 1003102989 | Eugenia Shmidt | Internal Medicine | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2011-06-20 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55454 |
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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.