NPIMap

Individual provider Active NPI

Leah R Radke, APRN,CNP

  • Family Nurse Practitioner
  • Detroit Lakes, MN
National Provider Identifier
1457070641
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9607 Issued in MN
Practice address
1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone
(218) 847-5611
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 19

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Regional Health Center 190 clinicians
Bridges Medical Center 22 clinicians

Practice addresses (Care Compare)

1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone (218) 847-5611

201 9TH St W
Ada, MN 56510-1279
Phone (218) 784-5000

Hospital & facility affiliations

  • Essentia Health St Marys - Detroit Lakes Hospital, Detroit Lakes, MN, CCN 240101
  • Essentia Health Ada Hospital, Ada, MN, CCN 241313
  • Essentia Health Hospital, Fargo, ND, CCN 350070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221031003058 MN Practitioner - Nurse Practitioner 3476920653 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R34159NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Regional Health Center CurrentSince Oct 24, 2022 Accepting new patients
Bridges Medical Center CurrentSince Oct 24, 2022 Accepting new patients
First Care Medical Services CurrentSince Oct 24, 2022 Accepting new patients
St. Marys Regional Health Center Current Accepting new patients
First Care Medical Services CurrentSince Jan 13, 2026 Accepting new patients
St Mary'S Regional Health Center CurrentSince Oct 24, 2022 Accepting new patients
Bridges Medical Center CurrentSince Jan 1, 2026 Accepting new patients
First Care Medical Services CurrentSince Oct 24, 2022 Accepting new patients
St Marys Regional Health Center Past Accepting new patients

Locations

201 9th St W
Ada, MN 56510
Phone (218) 784-2727

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

900 Hilligoss Blvd SE
Fosston, MN 56542
Phone (218) 435-1133

301 N Broadway
Pelican Rapids, MN 56572
Phone (218) 863-2000

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R34159 ND
Family Nurse Practitioner 363LF0000X 9607 MN Primary

Addresses

Primary practice location

1027 Washington Ave
Detroit Lakes, MN 56501-3409

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1457070641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013409",
            "telephone_number": "218-847-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKE",
        "first_name": "LEAH",
        "middle_name": "R",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R34159",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit Lakes, MN

Sources for this page

Verify at the official NPI Registry.