NPIMap

Organization Active NPI

Lakeview Memorial Hospital Association, Inc.

Doing business as Lakeview Hospice

  • Community Based Hospice Care Agency
  • Stillwater, MN
National Provider Identifier
1245225150
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC.
Doing business as
Lakeview Hospice
Practice address
5610 Norwich Pkwy
Stillwater, MN 55082-6481
Phone
(651) 430-3320
NPI assigned
Sep 16, 2005
Last updated
Aug 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Authorized official

Name
Brandi Lunneborg
Title
President
Phone
(651) 430-5207

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

5610 Norwich Pkwy
Stillwater, MN 55082-6481

Mailing address

5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone (651) 430-3320

Other identifiers 2

IdentifierTypeStateIssuer
43187200MedicaidWI
985845800MedicaidMN

Other names 1

  • Lakeview Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030523000035 MN Part A Provider - Hospice 1951210855 Practice locations: Oak Park Heights, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245225150. Details of each certification follow.

Hospice certification: CCN 241552

Legal name
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC.
Doing business as
LAKEVIEW HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 14, 1995
Last certification
Aug 23, 2018
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Apr 11, 1958 in MN
Enrollment address
5803 Neal Ave N
Mailstop 19501a
Oak Park Heights, MN 55082-2177

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Lakeview HospiceCCN 241552 · All quality measures
Ownership
Non-Profit
Certified
Mar 14, 1995
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Lakeview Mem Hosp-Crna8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

5803 Neal Ave N
Ste 330
Stillwater, MN 55082

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Jason Gallagher Individual Corporate Director Jan 1, 2024
Jack R Dressen Individual Corporate Director Jan 1, 2026
Khu Thao Individual Corporate Director Aug 1, 2023
Nicholas Weiss Individual Corporate Director Jan 1, 2026
Melissa Kolb Individual Corporate Director Apr 1, 2020
Miguel a Ruiz Diaz Individual W-2 Managing EmployeeMD; May 14, 2026
Michael Anderson Individual Corporate Director Jan 1, 2019
Stillwater Health System Organization, Stillwater, MN Operational/Managerial Control Jul 14, 2011
Sharon Tolva Individual Corporate Director Jan 1, 2019
Annie Jacobsen Individual Corporate Director Aug 1, 2023
Mark Gherty Individual Corporate Director May 1, 2018
Melody M Shepherd Individual W-2 Managing EmployeeMD; Jun 1, 2026
Richard G Dado Individual Corporate Director Jun 1, 2019
Criag Yehlik Individual Corporate Director Jan 1, 2020
Kris Tjornehoj Individual Corporate Director May 1, 2018
Levon O Haodha Individual Corporate Director Apr 1, 2018
Regan Brown Individual Corporate Director Jan 1, 2019
Alita R Risinger Individual Corporate OfficerChief Financial Officer Jul 1, 2024
Corporate DirectorVice President, Cfo Jan 1, 2024
Oralee Schock Individual Corporate Director May 1, 2017
Pahoua Hoffman Individual Corporate Director May 1, 2023
Lisa Bjorkman Individual W-2 Managing EmployeeAd; Jul 27, 2015
Paula Kolbeck Individual Corporate Director Jan 1, 2020
Charles Williamson Individual Corporate Director Mar 1, 2020
Steven Long Individual Corporate Director Oct 1, 2022

Owners & managing parties with NPI records 6

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785715200000",
    "number": "1245225150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-430-3320",
            "fax_number": "651-275-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 NORWICH PKWY",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826481",
            "telephone_number": "651-430-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A",
        "authorized_official_last_name": "LUNNEBORG",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-430-5207"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43187200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "985845800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.