Kimberly Jean Lakhan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9313 Issued in MN

Practice address

400 E 3Rd St
Duluth, MN 55805-1951

Phone

(218) 786-8364

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Hospital Superior Hospital, Superior, WI, CCN 521329
• Essentia Health Duluth Hospital, Duluth, MN, CCN 240019

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• St. Mary'S Hospital of Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Medicare reassignment NPD
• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• St. Mary'S Duluth Clinic Health System

  • Clinical Medical Laboratory
  • Superior, WI
  • NPI 1205866928
  NPD
• St. Mary'S Hospital of Superior

  • Critical Access Hospital Clinic/Center
  • Superior, WI
  • NPI 1588691588
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary'S Hospital of Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Care Compare affiliation
• St. Mary'S Hospital of Superior

  • Critical Access Hospital Clinic/Center
  • Superior, WI
  • NPI 1588691588
  Care Compare affiliation

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1023048238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKHAN",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42983200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "990887100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeside Dental Associates, PA
• Lakewalk Imaging, LLC
• Lakewalk Surgery Center, Inc.
• Lakewalk Surgery Center, Inc.
• Lakewind, Inc
• Frederick Reynold Lakso, PA
• Holly Laluzerne, MS ED.
• Lynne Elizabeth Lamar
• Timothy Scott Lamaster, M. D.
• Jacquelyn Lambert

• Physician Assistant in Duluth, MN
• Providers in Duluth, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.