NPIMap

Organization Active NPI

Lake Region Healthcare Corporation

Doing business as Lake Region Healthcare

  • Critical Access Hospital
  • Fergus Falls, MN
National Provider Identifier
1285525436
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
LAKE REGION HEALTHCARE CORPORATION
Doing business as
Lake Region Healthcare
Practice address
712 S Cascade St
Fergus Falls, MN 56537-2913
Phone
(218) 736-8000
NPI assigned
Jul 14, 2025
Last updated
Jul 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Chris Johnson
Title
Cfo
Phone
(218) 736-8687

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

712 S Cascade St
Fergus Falls, MN 56537-2913

Mailing address

712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (218) 736-8000

Other names 1

  • Lake Region Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20050210000490 MN Part B Supplier - Clinic/Group Practice 0648222349 Receives reassigned benefits from 203 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fergus Falls, MN; Morris, MN; Herman, MN; Evansville, MN; Elbow Lake, MN; Battle Lake, MN; Barnesville, MN; Ashby, MN
O20061104000667 MN Part A Provider - Critical Access Hospital 0648222349 Receives reassigned benefits from 170 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Morris, MN; Fergus Falls, MN; Ashby, MN; Battle Lake, MN; Evansville, MN; Elbow Lake, MN
O20071106000351 MN Part A Provider - Critical Access Hospital 0648222349 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elbow Lake, MN; Fergus Falls, MN
O20250929003770 MN MDPP Supplier - in-Person MDPP Supplier 0648222349 Practice locations: Fergus Falls, MN
O20251013001610 ND Part B Supplier - Clinic/Group Practice 0648222349 Receives reassigned benefits from 2 practitioners
Practice locations: Fargo, ND
O20260401000145 MN Part B Supplier - Intensive Cardiac Rehabilitation 0648222349 Receives reassigned benefits from 1 practitioner
Practice locations: Fergus Falls, MN

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1285525436. Details of each certification follow.

Hospital certification: CCN 241379

Legal name
PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES
Doing business as
LAKE REGION HEALTHCARE
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 6, 2005
Last certification
May 22, 2024
Beds
10
Ownership / control type
Private (not for profit)
Most recent change of ownership
Oct 1, 2025 (3 total)
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1994 in MN
Enrollment address
1411 Highway 79 E
Elbow Lake, MN 56531-4645
Main/Primary Hospital Location

Hospital certification: CCN 24Z379

Legal name
PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES
Doing business as
LAKE REGION HEALTHCARE
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1994 in MN
Enrollment address
1411 Highway 79 E
Elbow Lake, MN 56531-4645

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Prairie Ridge Hospital and Health ServicesCCN 241379 · 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
Tax ID family
Lake Region Healthcare Corporation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

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
Charles Macfarlane Individual Corporate DirectorBoard Member Jan 23, 2019
Prairie Ridge Hospital and Health Services Organization, Elbow Lake, MN Operational/Managerial Control Sep 25, 2007
Larry Goetzinger Individual Corporate DirectorBoard of Directors Oct 27, 2022
Dustin R Sperr Individual Corporate Director Jan 31, 2017
Corporate DirectorGoverning Board Trustee Jan 1, 2014
John Erickson Individual Corporate DirectorBoard Member Oct 23, 2003
Chris Johnson Individual Corporate OfficerCfo Aug 12, 2024
W-2 Managing Employee Aug 12, 2024
Operational/Managerial ControlCfo Aug 12, 2024
Laurel Nelson Individual Corporate DirectorBoard Member Jan 29, 2009
Felise Baer Individual W-2 Managing Employee Jul 15, 2017
W-2 Managing EmployeeReimbursement Coordinator Jul 15, 2017
Rebecca R Boesl Individual Corporate DirectorBoard Member Sep 30, 2021
Deborah Pelch Individual Corporate OfficerVP of Ambulatory Pro Service and Ca Feb 27, 2023
Operational/Managerial ControlVP of Ambulatory Prof Services and Feb 27, 2023
Corporate DirectorVP of Ambulatory Prof Services and Feb 27, 2023
Deborah Ferguson Individual Corporate DirectorBoard Member Jan 29, 2009
Aaron a Vasa Individual Corporate DirectorBoard Member Jan 31, 2025
Corporate DirectorBoard Member Jan 30, 2025
Jessica Steinbrenner Individual Corporate DirectorBoard Member Jul 25, 2024
Aric Risbrudt Individual Corporate DirectorAmbulance Services Director Apr 1, 2015
Corporate Director Apr 1, 2015
W-2 Managing Employee Apr 1, 2015
Chad D Miller Individual Corporate DirectorBoard Member Oct 27, 2022
Crystal Adams Individual Corporate DirectorBoard Member Sep 25, 2014
Corporate DirectorBoard of Directors Sep 25, 2014
Lake Region Healthcare Organization, Fergus Falls, MN Corporation, Non-profit Operational/Managerial Control Jan 1, 2015 100%
Justin Anderson Individual Corporate DirectorBoard Member Oct 28, 2021
Tindyl Rund Individual Corporate DirectorBoard Member Nov 2, 2023
Scott Bauer Individual Corporate DirectorBoard Member Oct 24, 2019
Erin Smith Individual Corporate DirectorBoard Member Jun 27, 2023
Jeanne Ennen Individual Corporate DirectorBoard Member May 1, 2021
Corporate DirectorBoard of Directors May 1, 2021
Kent Mattson Individual Corporate OfficerCeo Oct 1, 2017
Corporate DirectorBoard of Directors Oct 1, 2017
Michelle R Blair Individual W-2 Managing Employee Oct 1, 2019

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lake Region HealthcareElbow Lake, MN, CCN 241379 Hospital Operational/Managerial Control Sep 25, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 99

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.

View all 99

Affiliated clinicians 251

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

View all 251

NPI Registry JSON

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1285525436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S CASCADE ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372913",
            "telephone_number": "218-736-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 S CASCADE ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372913",
            "telephone_number": "218-736-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGION HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-14",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-736-8687"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Region Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.