Chi Lakewood Health | |
600 Main Ave S Baudette MN 56623-2855 | |
(218) 634-1655 | |
(218) 634-1094 |
Full Name | Chi Lakewood Health |
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Speciality | Clinic/Center |
Location | 600 Main Ave S, Baudette, Minnesota |
Authorized Official Name and Position | Jeffry A Stampohar (PRESIDENT) |
Authorized Official Contact | 2186342120 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Chi Lakewood Health 600 Main Ave S Baudette MN 56623-2855 Ph: (218) 634-1655 | Chi Lakewood Health 600 Main Ave S Baudette MN 56623-2855 Ph: (218) 634-1655 |
NPI Number | 1972799237 |
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Provider Enumeration Date | 09/20/2007 |
Last Update Date | 02/27/2020 |
Medicare PECOS PAC ID | 5698687929 |
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Medicare Enrollment ID | O20031104000469 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972799237 | NPI | - | NPPES |
199245700 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Michael J Clark |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215967898 PECOS PAC ID: 2961307194 Enrollment ID: I20031202000073 |
Provider Name | Daniel Joseph Margo |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1083727200 PECOS PAC ID: 2860398187 Enrollment ID: I20031209000272 |
Provider Name | Jerry R Bartleson |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1386686376 PECOS PAC ID: 0042102667 Enrollment ID: I20040625000032 |
Provider Name | Bruce M Dahlman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922058866 PECOS PAC ID: 3678559986 Enrollment ID: I20040628000518 |
Provider Name | David Javier Lopez |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1275629719 PECOS PAC ID: 0648241232 Enrollment ID: I20040805000876 |
Provider Name | Daniel S Vechell |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1275634628 PECOS PAC ID: 8426005414 Enrollment ID: I20050401000291 |
Provider Name | Fritz Leidig |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1871533851 PECOS PAC ID: 7113916305 Enrollment ID: I20050602000726 |
Provider Name | Bonita F Conner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497791115 PECOS PAC ID: 5799729281 Enrollment ID: I20050920000805 |
Provider Name | Rebecca J Poolman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598781353 PECOS PAC ID: 0749209609 Enrollment ID: I20051121000422 |
Provider Name | Janice G Carr-herseth |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1881816353 PECOS PAC ID: 0749290278 Enrollment ID: I20060428000162 |
Provider Name | Lawrence J Lorbiecki |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1437255932 PECOS PAC ID: 0840296562 Enrollment ID: I20061019000451 |
Provider Name | Mohan Kumas Bangalore Puttaiah |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619007697 PECOS PAC ID: 8123098738 Enrollment ID: I20070920000630 |
Provider Name | Suresh J Desilva |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1356304869 PECOS PAC ID: 4385619972 Enrollment ID: I20080409000542 |
Provider Name | Josephine M Mcintosh |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881797462 PECOS PAC ID: 5193751519 Enrollment ID: I20080613000502 |
Provider Name | Erika K Beckett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861649071 PECOS PAC ID: 9638230279 Enrollment ID: I20081202000100 |
Provider Name | Omotola O Jaiyebo |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1912077421 PECOS PAC ID: 3072579630 Enrollment ID: I20090219000673 |
Provider Name | Michelle L Fulp |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972782282 PECOS PAC ID: 0244300291 Enrollment ID: I20110701000229 |
Provider Name | Saravana Balaraman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972740488 PECOS PAC ID: 2365690070 Enrollment ID: I20120920000624 |
Provider Name | Mary Mackenburg Mohn |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073690012 PECOS PAC ID: 3577716158 Enrollment ID: I20130109000777 |
Provider Name | Justin Quo |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285947556 PECOS PAC ID: 9931342714 Enrollment ID: I20130826001067 |
Provider Name | Robert Anthony Wolfe |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205905452 PECOS PAC ID: 6901891928 Enrollment ID: I20160511002588 |
Provider Name | Debra J Lukenbill |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1265456370 PECOS PAC ID: 5294622569 Enrollment ID: I20161107001365 |
Provider Name | Michelle A Brown |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013452333 PECOS PAC ID: 1557554870 Enrollment ID: I20170221001002 |
Provider Name | Anna E Stein |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1790222404 PECOS PAC ID: 7315216470 Enrollment ID: I20170705000896 |
Provider Name | Dawn Page |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124557103 PECOS PAC ID: 5294006581 Enrollment ID: I20170804000796 |
Provider Name | Jordan Reese |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194215830 PECOS PAC ID: 5092066654 Enrollment ID: I20180920000676 |
Provider Name | Brian A Stanley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851661102 PECOS PAC ID: 8820242191 Enrollment ID: I20180928000135 |
Provider Name | Audrey J Brasel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952884041 PECOS PAC ID: 7315291879 Enrollment ID: I20181120000291 |
Provider Name | Dessa M Bergan |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1083197024 PECOS PAC ID: 3870847148 Enrollment ID: I20181127000018 |
Provider Name | Josephine Moore |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629340906 PECOS PAC ID: 9739337023 Enrollment ID: I20181127001876 |
Provider Name | Scott Harris |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1740402858 PECOS PAC ID: 5890835334 Enrollment ID: I20190805002641 |
Provider Name | Michelle Renee Lanning |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144876103 PECOS PAC ID: 6709115165 Enrollment ID: I20190910001928 |
Provider Name | Ashley A Malchow |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265066245 PECOS PAC ID: 8224469374 Enrollment ID: I20200506000180 |
Provider Name | Renee L Sandvik |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1649441304 PECOS PAC ID: 7315248846 Enrollment ID: I20200814001949 |
Provider Name | Brady S Anderson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1881212819 PECOS PAC ID: 5294154076 Enrollment ID: I20200928002608 |
Provider Name | Ronald Meador |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750570545 PECOS PAC ID: 2769426238 Enrollment ID: I20201006002204 |
Provider Name | Sarah J Gubbels |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1043532252 PECOS PAC ID: 2062701329 Enrollment ID: I20211220002349 |
Provider Name | Sheila D Bullock |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366943334 PECOS PAC ID: 8729342381 Enrollment ID: I20220422000536 |
Provider Name | Gina Ann Lablanc |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669198040 PECOS PAC ID: 3779952395 Enrollment ID: I20221202002647 |
Provider Name | Allison Odell |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1861668972 PECOS PAC ID: 2264458942 Enrollment ID: I20230216002210 |
Provider Name | Sharon Falke |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578591947 PECOS PAC ID: 8527024264 Enrollment ID: I20231024003575 |
Lakewood Health Center Rhc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 Main Ave S, Baudette, MN 56623 Phone: 218-634-1655 Fax: 218-634-1094 |