NPIMap

Organization Active NPI

Lake View Memorial Hospital, Inc

Doing business as Aspirus Lake View Silver Bay Clinic

  • Family Medicine Physician
  • Silver Bay, MN
National Provider Identifier
1194344044
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAKE VIEW MEMORIAL HOSPITAL, INC
Doing business as
Aspirus Lake View Silver Bay Clinic
Practice address
50 Outer Dr
Silver Bay, MN 55614-1102
Phone
(218) 226-4431
NPI assigned
Apr 10, 2020
Last updated
May 23, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
LAKE VIEW MEMORIAL HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Greg Garrett Ruberg
Title
President/Ceo
Phone
(218) 834-7345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

50 Outer Dr
Silver Bay, MN 55614-1102

Mailing address

50 Outer Dr
Silver Bay, MN 55614-1102

Other names 1

  • Aspirus Lake View Silver Bay Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000685 MN Part A Provider - Critical Access Hospital 9032002688 Receives reassigned benefits from 90 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Silver Bay, MN; Two Harbors, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194344044. Details of each certification follow.

Hospital certification: CCN 241308

Legal name
LAKE VIEW MEMORIAL HOSPITAL, INC
Doing business as
ASPIRUS LAKE VIEW HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2000
Last certification
May 2, 2024
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Nov 16, 1953 in MN
Enrollment address
325 11TH Ave
Two Harbors, MN 55616-1300
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Aspirus Lake View HospitalCCN 241308 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Lake View Memorial Hospital

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

50 Outer Dr
Silver Bay, MN 55614
Phone (218) 226-4431

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Richard Hogenson Individual Corporate DirectorBoard Member Jan 27, 2016
Jerry M Yang Individual Corporate OfficerSVP & Chief Financial Officer Mar 1, 2024
W-2 Managing EmployeeSVP & Chief Financial Officer Mar 1, 2024
Nathan J Cavallin Individual Corporate DirectorDirector-Finance Jun 1, 2017
W-2 Managing EmployeeDirector-Finance Jun 1, 2017
Kiera Marie Wilson Individual Corporate DirectorBoard Member May 26, 2021
Chris L Brelie Individual Corporate DirectorBoard Member May 26, 2021
Janelle Jones Individual Corporate DirectorBoard Member Jan 28, 2015
Aspirus, Inc Organization, Wausau, WI Corporation, Non-profit, Chain home office Operational/Managerial Control Mar 1, 2024
Greg G Ruberg Individual Corporate OfficerPresident/Ceo Jul 12, 2014
Kevin Beardsley Individual Corporate DirectorBoard Member Jan 1, 2010
St. Luke's Hospital of Duluth Organization, Duluth, MN 5% Or Greater Direct Ownership Interest Jan 1, 2010 100%
Joyce Scott Individual Corporate DirectorBoard Member May 20, 2020
Wade Leblanc Individual Corporate DirectorBoad Member Jun 1, 2012
Lori Peck Individual W-2 Managing EmployeeVP - Finance Mar 1, 2024
Kelsey M Schultz Individual Corporate OfficerBoard Member Apr 23, 2023
Tyler Hack Individual W-2 Managing EmployeeVP - Revenue Cycle Mar 1, 2024

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 149

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 149

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1194344044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 OUTER DR",
            "city": "SILVER BAY",
            "state": "MN",
            "postal_code": "556141102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 OUTER DR",
            "city": "SILVER BAY",
            "state": "MN",
            "postal_code": "556141102",
            "telephone_number": "218-226-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE VIEW MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKE VIEW MEMORIAL HOSPITAL, INC",
        "enumeration_date": "2020-04-10",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "RUBERG",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "GARRETT",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "218-834-7345"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspirus Lake View Silver Bay Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Silver Bay, MN

Sources for this page

Verify at the official NPI Registry.