Lakes Imaging LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

LAKES IMAGING LLC

Practice address

2019 S 6TH St
Brainerd, MN 56401-4528

Phone

(218) 822-4242

Fax

(218) 822-3758

NPI assigned

Jul 9, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Holmen, M.D.NPI 1912931783

Title

President

Phone

(218) 822-4242

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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.

• John H Holmen, M.D.

  • Diagnostic Radiology Physician
  • Bismarck, ND
  • NPI 1912931783
  NPD (past) Authorized official

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437182839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014528",
            "telephone_number": "218-822-4242",
            "fax_number": "218-822-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014528",
            "telephone_number": "218-822-4242",
            "fax_number": "218-822-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLMEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-822-4242",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFFERED ONE",
            "identifier": "1033922",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "171008",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Leigh Kulzer, PT, DPT
• Lake County Dental LTD
• Samantha Rae Lake, LICSW
• Lakes Area Consultation Services LLC
• Lakes Area Urology PA
• Lang Chiropractic Clinic PA (Lakes Chiropractic)
• Jay K Lang, DC
• James Vincent Lange, LADC
• Mary Lange, RD
• Nathan David Laposky, MD

• Radiology Clinic/Center in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Radiology Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.