Individual provider Active NPI

Luke Funk

  • Psychiatric/Mental Health Nurse Practitioner
  • Brainerd, MN
National Provider Identifier
1003676263
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11416 Issued in MN
Practice address
411 Front St
Brainerd, MN 56401-3516
Phone
(218) 327-2001
NPI assigned
Mar 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11416 MN Primary

Addresses

Primary practice location

411 Front St
Brainerd, MN 56401-3516

Mailing address

411 Front St
Brainerd, MN 56401-3516
Phone (218) 327-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240711000946 MN Practitioner - Nurse Practitioner 8325583651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeview Behavioral Health IncGroup PAC ID 9537432307, 24 clinicians

Practice addresses (Care Compare)

516 S Pokegama Ave
Grand Rapids, MN 55744-3800
Phone (218) 327-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11416MNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Behavioral Health Inc. CurrentSince Apr 28, 2024 Accepting new patients
Blue Sky Therapy, LLC PastSince Mar 24, 2024 Accepting new patients
Cornerstone Counseling Center, PLLC PastSince Mar 24, 2024 Accepting new patients

Locations

516 S Pokegama Ave
Grand Rapids, MN 55744
Phone (218) 327-2001

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1003676263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FRONT ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013516",
            "telephone_number": "218-327-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FRONT ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013516",
            "telephone_number": "218-327-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "LUKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "11416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.