LAKES AREA HEALTH CENTER, PLLC (NPI# 1902392830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902392830 |
| Entity Type | Organization |
| Organization Name | LAKES AREA HEALTH CENTER, PLLC |
| Practice Address |
360 Sherman St Ste 400 Saint Paul MN 55102-2425 |
| Practice Telephone | 6512251102 |
| Practice Fax Number | 6129771208 |
| Mailing Telephone | 6512251102 |
| Mailing Fax Number | 6129771208 |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2018-07-03 |
| Authorized Official Name | LEANN ROSE OTTOMEYER (OFFICER) |
| Authorized Official Telephone | 6514641113 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | LAKES AREA HEALTH CENTER, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851887780 | Lakes Area Health Center, Pllc | Physical Therapist | 360 Sherman St Ste 400, Saint Paul, MN 55102-2425 | 2018-07-03 |
| 1578059408 | Lakes Area Health Center, Pllc | Physical Therapist | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2095 | 2018-07-03 |
| 1467948398 | Lakes Area Health Center, Pllc | General Practice | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2095 | 2018-07-03 |
| 1467403030 | Lakes Area Health Center, Pllc | Clinic/Center | 967 Lake St S, Forest Lake, MN 55025 | 2006-05-16 |
| Street Address |
360 SHERMAN ST STE 400 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55102-2425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972980852 | Geriatric & Rehabilitation Consultants Ein | Specialist | 360 Sherman St Ste 400, Saint Paul, MN 55102-2425 | 2015-04-30 |
| 1689150120 | Lakes Area Health System | Clinic/Center | 360 Sherman St Ste 400, Saint Paul, MN 55102-2425 | 2018-07-18 |
| 1023594215 | Emily Jean Peterson | Chiropractor | 360 Sherman St Ste 400, Saint Paul, MN 55102 | 2018-07-11 |
| 1851887780 | Lakes Area Health Center, Pllc | Physical Therapist | 360 Sherman St Ste 400, Saint Paul, MN 55102-2425 | 2018-07-03 |
| 1255865267 | Lakes Area Health Center | Clinic/Center | 360 Sherman St Ste 400, Saint Paul, MN 55102-2425 | 2017-04-17 |
| 1881057651 | James Bradley Dietz | Chiropractor | 360 Sherman St Ste 400, Saint Paul, MN 55102 | 2016-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720623366 | Ning Wu | Acupuncturist | Tcm Health Center, 613 Grand Ave., St. Paul, MN 55102 | 2019-11-07 |
| 1730730615 | Tianwei Guo | Acupuncturist | 613 Grand Avenue, Saint Paul, MN 55102 | 2019-09-23 |
| 1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
| 1699329169 | Elisabeth Johanna Wurtmann | Genetic Counselor, MS | 310 N Smith Avenue Suite 300, Saint Paul, MN 55102 | 2019-08-01 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1922505098 | Women of Nations | Substance Abuse Rehabilitation Facility | 73 Leech Street, St. Paul, MN 55102 | 2018-04-06 |
| 1609371939 | Courtney Marie Klinkhammer | Student in an Organized Health Care Education/Training Program | 1026 West Seventh Street, St. Paul, MN 55102 | 2018-03-28 |
| 1427429372 | Compass Pathology and Consulting | Clinical Medical Laboratory | 360 Sherman St Suite 400b, St. Paul, MN 55102 | 2015-10-16 |
| 1639550494 | Daniel Delapp | Speech-Language Pathologist | United Hospital 333 Smith Avenue N, Mail Route 60104, St. Paul, MN 55102 | 2015-06-17 |
| 1124419940 | Suzanne Carl | Speech-Language Pathologist | 360 Colborne Avenue, St. Paul, MN 55102 | 2015-02-16 |
| Find all providers in zip 55102 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063659647 | The Institute for Exercise Medicine and Prevention | General Practice | 2935 Country Dr, Suite 103, Saint Paul, MN 55117-1183 | 2009-01-19 |
| 1730330127 | Gloria Jeanne Scoonover | General Practice | 679 3rd Ave, Saint Paul, MN 55118-2811 | 2008-10-03 |
| 1417453366 | Risa Bache-wiig | General Practice | 1414 Maryland Ave E, Saint Paul, MN 55106-2824 | 2018-03-31 |
| 1447784608 | Christopher Culhane | General Practice | 580 Rice St, Saint Paul, MN 55103-2148 | 2017-04-14 |
| 1891058384 | Proactive Healthcare | General Practice | 101 5th St E, Suite 227, Saint Paul, MN 55101-1898 | 2012-06-19 |
| 1750561478 | Raheela Ayub | General Practice | 205 Wabasha St S, Mail Stop: 31300a, Saint Paul, MN 55107-1805 | 2007-11-09 |
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|---|---|---|---|---|
| 1447857230 | Minneapolis Integrative Medicine Center, LLC | General Practice | 575 9th St Se Ste 52, Minneapolis, MN 55414-1399 | 2020-10-05 |
| 1811518137 | Falls Medical Group, Pllc | General Practice | 1580 Highway 11-71, International Falls, MN 56649 | 2020-04-27 |
| 1013561893 | Medexpress Primary Care Minnesota, P.C. | General Practice | 4316 Rice Lake Rd, Duluth, MN 55811-4012 | 2019-07-30 |
| 1245790211 | Fairview Clinics | General Practice | 303 E Nicollet Blvd Ste 260, Burnsville, MN 55337-4522 | 2019-03-25 |
| 1316422397 | Fairview Health Services | General Practice | 7411 85th Ave N, Brooklyn Park, MN 55445-2231 | 2018-09-26 |
| 1841716883 | Medexpress Primary Care Minnesota, P.C. | General Practice | 11030 Optum Cir, Eden Prairie, MN 55344-2503 | 2017-08-22 |
| 1447654678 | Chs Tennessee Medical, P.C. | General Practice | 610 Opperman Dr, Thomson Reuters Campus, Eagan, MN 55123-1340 | 2014-10-17 |
| 1922422989 | Roger J. Day | General Practice | 9701 Xebec St Ne, Circle Pines, MN 55014-2508 | 2014-02-12 |
| 1760724827 | Ahmednur Abdirahman | General Practice | 10750 Brunswick Rd Apt 111, Bloomington, MN 55438-1860 | 2013-03-26 |
| 1225385891 | Felix Cristobal Blanco | General Practice | 10 Fourth Ave Se, Glenwood, MN 56334-1820 | 2012-08-13 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55102 |
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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.