| Lakeview Clinic, Ltd. | |
|
424 W State Highway 5 Waconia MN 55387-1723 | |
| (952) 442-4461 | |
| (952) 442-1547 |
| Full Name | Lakeview Clinic, Ltd. |
|---|---|
| Speciality | Clinic/Center |
| Location | 424 W State Highway 5, Waconia, Minnesota |
| Authorized Official Name and Position | Robert W. Wilcox (ADMINISTRATOR) |
| Authorized Official Contact | 9524424461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeview Clinic, Ltd. 424 W State Highway 5 Waconia MN 55387-1723 Ph: (952) 442-4461 | Lakeview Clinic, Ltd. 424 W State Highway 5 Waconia MN 55387-1723 Ph: (952) 442-4461 |
| NPI Number | 1669599981 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 01/25/2012 |
| Medicare PECOS PAC ID | 6002801453 |
|---|---|
| Medicare Enrollment ID | O20040416000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669599981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Kristin J Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124002548 PECOS PAC ID: 6608764816 Enrollment ID: I20040309000801 |
| Provider Name | Tracy A Jackson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821177692 PECOS PAC ID: 9739174947 Enrollment ID: I20040417000067 |
| Provider Name | Sandra Z Beulke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780630707 PECOS PAC ID: 6507892072 Enrollment ID: I20050715000498 |
| Provider Name | Paul E Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073690327 PECOS PAC ID: 4082609359 Enrollment ID: I20050715000628 |
| Provider Name | James E Carrabre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932148046 PECOS PAC ID: 0345235610 Enrollment ID: I20050715000639 |
| Provider Name | Todd D Elftmann |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689751943 PECOS PAC ID: 7618962986 Enrollment ID: I20050715000684 |
| Provider Name | David B Haugland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043259773 PECOS PAC ID: 5597750869 Enrollment ID: I20050715000851 |
| Provider Name | Todd A Holcomb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184703951 PECOS PAC ID: 2860487139 Enrollment ID: I20050715000901 |
| Provider Name | Mark R Larose |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972682680 PECOS PAC ID: 9133114408 Enrollment ID: I20050719000835 |
| Provider Name | Jonathan M Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356420079 PECOS PAC ID: 1658366919 Enrollment ID: I20050719000860 |
| Provider Name | Bradley J Ludwig |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528147279 PECOS PAC ID: 4789611054 Enrollment ID: I20050719000911 |
| Provider Name | Amy J Meath |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063591725 PECOS PAC ID: 6709871080 Enrollment ID: I20050719000930 |
| Provider Name | Kevin A Taylor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598844136 PECOS PAC ID: 9234124504 Enrollment ID: I20050720000299 |
| Provider Name | Eric Blair Wentling |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366521916 PECOS PAC ID: 7810924073 Enrollment ID: I20050720000389 |
| Provider Name | Heidi R Wuerger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649359209 PECOS PAC ID: 3678568946 Enrollment ID: I20050720000410 |
| Provider Name | Thomas J Bryan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285695528 PECOS PAC ID: 9830115310 Enrollment ID: I20051024000757 |
| Provider Name | Anne M Benolken |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780657254 PECOS PAC ID: 8921902453 Enrollment ID: I20060524000074 |
| Provider Name | Jaimee D Mcpadden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891725727 PECOS PAC ID: 6103824628 Enrollment ID: I20061117000039 |
| Provider Name | Lori Lynn Wischnack Melby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982705059 PECOS PAC ID: 6002870755 Enrollment ID: I20080111000516 |
| Provider Name | Laura A Mohling |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689683880 PECOS PAC ID: 9133282940 Enrollment ID: I20090105000580 |
| Provider Name | Tara L Mcmichael |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134368160 PECOS PAC ID: 6406907245 Enrollment ID: I20090708000015 |
| Provider Name | Dawn M Stapleton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811068935 PECOS PAC ID: 1355534074 Enrollment ID: I20101026000380 |
| Provider Name | Jennifer K Ische |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669608352 PECOS PAC ID: 8022298819 Enrollment ID: I20110210001172 |
| Provider Name | Sarah E Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710153325 PECOS PAC ID: 1759561483 Enrollment ID: I20110211000578 |
| Provider Name | Boriana I Petkov |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942378872 PECOS PAC ID: 4284805706 Enrollment ID: I20110913000882 |
| Provider Name | Timothy M Thormodsgard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063611770 PECOS PAC ID: 8426206467 Enrollment ID: I20120917000077 |
| Provider Name | Erin L Chinnock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255573416 PECOS PAC ID: 5890936066 Enrollment ID: I20130731000109 |
| Provider Name | Benjamin Michael Scherschligt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578875795 PECOS PAC ID: 2567602717 Enrollment ID: I20140721000122 |
| Provider Name | Peter H Rogers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396060281 PECOS PAC ID: 3971729716 Enrollment ID: I20140730002853 |
| Provider Name | Elizabeth A Hopfenspirger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457744047 PECOS PAC ID: 9234458373 Enrollment ID: I20150512001176 |
| Provider Name | Erin K Dahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487037073 PECOS PAC ID: 1254645302 Enrollment ID: I20150803000779 |
| Provider Name | Lorene Elise Rutherford |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821177502 PECOS PAC ID: 4082609441 Enrollment ID: I20151109002008 |
| Provider Name | David Jc Arens |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1407199110 PECOS PAC ID: 6305138025 Enrollment ID: I20160715001454 |
| Provider Name | Lisa M Chapman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609033364 PECOS PAC ID: 5991090201 Enrollment ID: I20160825002450 |
| Provider Name | Victoria K Zbikowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316367063 PECOS PAC ID: 1658675970 Enrollment ID: I20170104002008 |
| Provider Name | Leah Margaret Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679923379 PECOS PAC ID: 7810289063 Enrollment ID: I20170802002746 |
| Provider Name | Abigail K Elliott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295180586 PECOS PAC ID: 2961794680 Enrollment ID: I20170814002210 |
| Provider Name | Alicia C Pysick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518464601 PECOS PAC ID: 2466717681 Enrollment ID: I20180517001011 |
| Provider Name | Daniel J Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497281968 PECOS PAC ID: 6002185675 Enrollment ID: I20190416002169 |
| Provider Name | Kathryn N Howell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033571278 PECOS PAC ID: 9537453824 Enrollment ID: I20200416001640 |
| Provider Name | Rebecca L Siffring |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245765742 PECOS PAC ID: 2961735303 Enrollment ID: I20200804002074 |
| Provider Name | Natalie E Stoltman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619474673 PECOS PAC ID: 6002166998 Enrollment ID: I20210126002851 |
| Provider Name | Lucas P Labine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285137026 PECOS PAC ID: 0749531879 Enrollment ID: I20210826000023 |
| Provider Name | Tessa Somermeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003439969 PECOS PAC ID: 5193102069 Enrollment ID: I20220513002158 |
| Provider Name | Jonathan J Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003479171 PECOS PAC ID: 3678807658 Enrollment ID: I20220726002672 |
| Provider Name | Jordyn N Walter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881155729 PECOS PAC ID: 2163750472 Enrollment ID: I20220830004017 |
| Provider Name | Steven Von Seggern Turner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619479334 PECOS PAC ID: 6507111093 Enrollment ID: I20230717001577 |
| Provider Name | Heather J Hagen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922448877 PECOS PAC ID: 5890929913 Enrollment ID: I20240520003148 |
| Provider Name | Laurel L Erickson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669551495 PECOS PAC ID: 7113912486 Enrollment ID: I20240605000803 |
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