Liberty Health PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LIBERTY HEALTH PLLC

Practice address

1361 Wenner Rd
Detroit Lakes, MN 56501-7918

Phone

(218) 396-6500

NPI assigned

Nov 10, 2021

Organization subpart

No

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

Authorized official

Name

Scott Allen Lawrence, MDNPI 1407874076

Title

Clinical Director

Phone

(218) 779-7005

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Allen Lawrence, MD

  • Family Medicine Physician
  • Detroit Lakes, MN
  • NPI 1407874076

  MN

  Medicare reassignment Care Compare group NPD Authorized official
• Renae L Miller, PA-C

  • Medical Physician Assistant
  • Detroit Lakes, MN
  • NPI 1669523718

  MN

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1093471484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 WENNER RD",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565017918",
            "telephone_number": "218-396-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 WENNER RD",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565017918",
            "telephone_number": "218-396-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "218-779-7005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey L Leichter, PHD
• Bruce Lemon
• Jane P Leno, OTR/L
• Jennifer K Lessman, PA-C
• Laura Lou Lhotka, MD
• Life Choices Counseling
• Lincare Inc.
• Erin Nichole Lindberg, OTR/L
• Jessica Lindblom, CNP
• Mark David Lindquist, MD

• All providers in Detroit Lakes, MN
• Multi-Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.