NPIMap

Organization Active NPI

Lakewood Health System

  • Non-Pharmacy Dispensing Site
  • Staples, MN
National Provider Identifier
1053911545
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
LAKEWOOD HEALTH SYSTEM
Practice address
49725 County Rd 83
Staples, MN 56479
Phone
(952) 653-2525
Fax
(952) 653-2540
NPI assigned
Oct 26, 2020
Last updated
Jun 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Joseph T Reycraft
Title
Cfo
Phone
(218) 894-8194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

49725 County Rd 83
Staples, MN 56479

Mailing address

49725 County Rd 83
Staples, MN 56479
Phone (952) 653-2525

National Provider Directory

National Provider Directory
Tax ID family
North Memorial Health Care14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1053911545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY RD 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "56479",
            "telephone_number": "952-653-2525",
            "fax_number": "952-653-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49725 COUNTY RD 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "56479",
            "telephone_number": "952-653-2525",
            "fax_number": "952-653-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-26",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "REYCRAFT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-894-8194"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staples, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.