MAYO CLINIC HEALTH SYSTEM-LAKE CITY (NPI# 1891710893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891710893 |
| 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 |
| Practice Fax Number | 6513451151 |
| Mailing Telephone | 6513453321 |
| Mailing Fax Number | 6513451151 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2017-12-29 |
| Authorized Official Name | CHARLOTTE NORDRUM (CFO) |
| Authorized Official Telephone | 5075381446 |
| Is Organization Subpart | Y |
| Parent Organization Name | MAYO CLINIC HEALTH SYSTEM - LAKE CITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | Hospital Units |
| 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 |
| 1164463659 | Mayo Clinic Health System-lake City | Clinic/Center | 500 W Grant St, Lake City, MN 55041-1143 | 2006-06-08 |
| 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 | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912410804 | Lake Shore Hma, LLC | Medicare Defined Swing Bed Unit | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2017-11-14 |
| 1790850865 | Lower Florence County Hospital | Medicare Defined Swing Bed Unit | 258 N Ron Mcnair Blvd, Lake City, SC 29560-2462 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881039659 | Metropolitan Health Medical Center | Medicare Defined Swing Bed Unit | 3055 Old Highway 8 Ste 2, St Anthony, MN 55418-2500 | 2013-05-07 |
| 1952359614 | Centracare Health System - Long Prairie | Medicare Defined Swing Bed Unit | 50 Centracare Dr, Long Prairie, MN 56347 | 2006-05-05 |
| 1952370348 | City of Sleepy Eye | Medicare Defined Swing Bed Unit | 400 4th Ave Nw, Sleepy Eye, MN 56085-1109 | 2006-03-16 |
| 1932738218 | Essentia Health Moose Lake | Medicare Defined Swing Bed Unit | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2020-04-07 |
| 1578106498 | Avera Granite Falls | Medicare Defined Swing Bed Unit | 345 10th Ave, Granite Falls, MN 56241-1442 | 2019-10-23 |
| 1285116061 | Carris Health - Redwood LLC | Medicare Defined Swing Bed Unit | 100 Fallwood Rd, Redwood Falls, MN 56283-1828 | 2018-08-29 |
| 1578078036 | Winona Health Services | Medicare Defined Swing Bed Unit | 855 Mankato Ave, Winona, MN 55987-4868 | 2017-12-06 |
| 1649705690 | Stevens Community Medical Center Inc | Medicare Defined Swing Bed Unit | 400 E. 1st Street, Morris, MN 56267 | 2017-04-27 |
| 1316374978 | Bridges Medical Center | Medicare Defined Swing Bed Unit | 201 9th St W, Ada, MN 56510-1279 | 2013-09-27 |
| 1457786972 | Centracare Health-paynesville LLC | Medicare Defined Swing Bed Unit | 200 W 1st St, Paynesville, MN 56362-1445 | 2013-09-04 |
| Find all providers with the same taxonomy | ||||
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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.