Horseshoe Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

HORSESHOE SURGERY CENTER, LLC

Practice address

1542 Golf Course Rd
Suite 105
Grand Rapids, MN 55744-9603

Phone

(218) 326-0667

Fax

(218) 326-3435

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Kelly Skelly

Title

Executive Director

Phone

(218) 326-3937

Specialties & licenses 1

Addresses

Other names 1

• Lakewood Surgery Center Doing business as

Listed as

Orseshoe Surgery Center LLC Dba Lakewood Surgery CenterCCN 24C0001053

Medicare certification status

Terminated Voluntary: merger or closure, Feb 2, 2025From the Provider of Services file

Member of 1

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

• The Duluth Clinic LTD

  • Urgent Care Clinic/Center
  • Duluth, MN
  • NPI 1902459209

  Member Of

  NPD member

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580256000000",
    "number": "1265487474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD",
            "address_2": "SUITE 105",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557449603",
            "telephone_number": "218-326-0667",
            "fax_number": "218-326-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD",
            "address_2": "SUITE 105",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557449603",
            "telephone_number": "218-326-0667",
            "fax_number": "218-326-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORSESHOE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A",
        "authorized_official_last_name": "SKELLY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "218-326-3937"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakewood Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Christine Holthus
• Elizabeth Kate Hongo, LADC
• Hope House of Itasca County, Inc.
• Hope House of Itasca County, Inc.
• Lauren Hopp
• Denise Ann Hove, CCC/AUD
• Christina Marie Hubred, A D.T., DH
• Kerrie Rae Humble, MSW, LICSW
• Philip Bruce Imholte, M.D.
• Ind School District 318

• Ambulatory Surgical Clinic/Center in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Ambulatory Surgical Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.