NPIMap

Organization Active NPI

Lakes Regional Healthcare

  • Family Medicine Physician
  • Spirit Lake, IA
National Provider Identifier
1306100615
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAKES REGIONAL HEALTHCARE
Practice address
2700 23Rd St Ste C
Spirit Lake, IA 51360-1158
Phone
(712) 336-3750
Fax
(712) 336-3730
NPI assigned
Jul 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Authorized official

Name
Mr. Steve J Alger
Title
Sr VP and Cfo
Phone
(712) 336-8796

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X IA Primary

Addresses

Primary practice location

2700 23Rd St Ste C
Spirit Lake, IA 51360-1158

Mailing address

2700 23Rd St Ste C
Spirit Lake, IA 51360-1158
Phone (712) 336-3750

Other names 1

  • Avera Medical Group - Lakes Family Practice a Department of Lakes Regi Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031223000386 IA Part B Supplier - Clinic/Group Practice 0941118442 Receives reassigned benefits from 66 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spirit Lake, IA; Sibley, IA; Estherville, IA

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Lakes Regional Healthcare11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1306100615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 23RD ST STE C",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "513601158",
            "telephone_number": "712-336-3750",
            "fax_number": "712-336-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 23RD ST STE C",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "513601158",
            "telephone_number": "712-336-3750",
            "fax_number": "712-336-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES REGIONAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "ALGER",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR VP AND CFO",
        "authorized_official_telephone_number": "712-336-8796",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group - Lakes Family Practice a Department of Lakes Regi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spirit Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.