NPIMap

Organization Active NPI

Lakewood Health System

Doing business as Lakewood Health System Home Care and Hospice

  • Home Health Agency
  • Staples, MN
National Provider Identifier
1477544542
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LAKEWOOD HEALTH SYSTEM
Doing business as
Lakewood Health System Home Care and Hospice
Practice address
401 Prairie Ave NE
Staples, MN 56479-3201
Phone
(218) 894-1515
Fax
(218) 898-7596
NPI assigned
Oct 28, 2005
Last updated
Jun 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Joseph T Reycraft
Title
Cfo
Phone
(218) 894-8194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X MN Primary

Addresses

Primary practice location

401 Prairie Ave NE
Staples, MN 56479-3201

Mailing address

49725 County 83
Staples, MN 56479-5280
Phone (218) 894-1515

Other names 1

  • Lakewood Health System Home Care and Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090819000852 MN Part A Provider - Home Health Agency 1052229671 Practice locations: Staples, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477544542. Details of each certification follow.

Home health agency certification: CCN 247124

Legal name
LAKEWOOD HEALTH SYSTEM
Doing business as
LAKEWOOD HEALTH SYSTEM HOME CARE AND HOSPICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 28, 1982
Last certification
Jun 14, 2018
Ownership / control type
Non-Profit
Organization structure
OtherNon-profit
Enrollment address
401 Prairie Ave NE
Staples, MN 56479-3201
HHA Branch

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Care Compare: Home health agency

Medicare Care Compare
Listed as
Lakewood Health System Home Care & HospiceCCN 247124 · All quality measures
Overall star rating
2 of 5
Ownership
Non-Profit
Certified
Dec 28, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
North Memorial Health Care14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 34

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Melissa Beth Lindow Individual Corporate OfficerChief Operating Officer Aug 27, 2023
Operational/Managerial ControlChief Operating Officer Aug 27, 2023
Billy Joe Haehnel Individual Corporate Director Nov 1, 2015
Joseph Thomas Reycraft Individual Corporate OfficerCfo Aug 28, 2022
Operational/Managerial ControlCfo Aug 28, 2022
Curtis Eugene McIlravy Individual Corporate OfficerSystem Board Chair Jul 1, 2014
Ryan David Kray Individual Corporate DirectorBoard Member Oct 1, 2021
Robert Michael Mueller Individual Corporate DirectorDistrict Vice Chair Jun 25, 2015
Sara Jane Grove Individual Corporate Director Apr 24, 2014
Craig Thomas Wolhowe Individual Corporate OfficerVP of Clinic/Hospital Services Jun 11, 1997
Operational/Managerial ControlVP of Clinic/Hospital Services Jun 11, 1997
Alicia Kay Bauman Individual Corporate OfficerChief Talent Officer Oct 9, 2022
Operational/Managerial ControlChief Talent Officer Oct 9, 2022
Mary Martha Theurer Individual Corporate OfficerDistrict Chair / System Secretary Jan 1, 2010
Elizabeth Ann Pottratz Individual Corporate DirectorBoard Member Jan 1, 2023
Lisa Marie Bjerga Individual Corporate OfficerCeo/President Mar 7, 2016
Operational/Managerial ControlCeo/President Mar 7, 2016
Kaitlyn Rose Schoeck Individual Corporate DirectorBoard Member Aug 7, 2017
Lana Ellen Hansen Individual Corporate OfficerDistrict Secretary Jan 1, 2008
Ronald Alvin Storbakken Individual Corporate Director Jan 1, 2000
Franz Harry Achermann Individual Corporate DirectorBoard Member Jan 1, 2025
Kathleen Marie Dobson Individual Operational/Managerial ControlVP of Senior Services Dec 1, 2014
James Alan Roeder Individual Operational/Managerial ControlVP of Information Technology Jan 1, 2018
Mary Ann Fitcher Individual Corporate DirectorBoard Member Jan 1, 2025
Brad Richard Anderson Individual Corporate OfficerChief Development Officer Aug 13, 2014
Operational/Managerial ControlChief Development Officer Aug 13, 2014
Amy Jo Brichacek Individual Corporate DirectorBoard Member Jan 1, 2021
Emil Paul Wicht Individual Corporate Director Jan 1, 1973
Melissa Sue Daniels Individual W-2 Managing EmployeeExecutive Assistant to the Cfo Sep 15, 2016
Michael Lee Austin Individual Operational/Managerial ControlVP of Clinic Services Dec 30, 2024
Norman Harold Krause Individual Corporate DirectorMember Jul 1, 2018
Daniel John Douts Individual Corporate DirectorBoard Member May 1, 2024
Susan Kay Peet Individual Corporate DirectorDistrict Treasurer Jan 1, 2021
Wade Thomas Swenson Individual Corporate DirectorBoard Member Jan 1, 2023
Lindsay Rae Leveille Individual Corporate DirectorBoard Member Jul 1, 2023
Christine Sara Albrecht Individual Corporate Director Jun 30, 2009
Sarah Ann Jennissen Individual Corporate DirectorBoard Member Jul 1, 2024
Beverly Jean Hoemberg Individual Corporate Director Jan 1, 2011
Jef Richard Cichos Individual Corporate DirectorSystem Vice Chair Jul 1, 2016
Sarah Jane Baumgartner Individual Operational/Managerial ControlVP of Nursing Jul 1, 2024

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 3

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

FacilityTypeRoleSince
Lakewood ClinicStaples, MN, CCN 243422 Rural health clinic 5% Or Greater Direct Ownership Interest
General Partnership Interest		 Apr 1, 1997
Apr 1, 1997
Lakewood Clinic-BrowervilleEagle Bend, MN, CCN 243421 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1997
Lakewood Clinic-PillagerPillager, MN, CCN 243436 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Mar 1, 1998
Mar 1, 1998

Owned or controlled facilities with NPI records 3

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

  • Lakewood Health System

    dba Lakewood Clinic Eagle Bend

    • Rural Health Clinic/Center
    • Eagle Bend, MN
    • NPI 1093706160

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lakewood Health System

    dba Lakewood Clinic Pillager

    • Rural Health Clinic/Center
    • Pillager, MN
    • NPI 1811988983

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lakewood Health System

    dba Lakewood Clinic Staples

    • Rural Health Clinic/Center
    • Staples, MN
    • NPI 1841280823

    5% Or Greater Direct Ownership Interest, General Partnership Interest

    CMS ownership

Practitioners & affiliated clinicians

Affiliated clinicians 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1477544542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-898-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PRAIRIE AVE NE",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564793201",
            "telephone_number": "218-894-1515",
            "fax_number": "218-898-7596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "REYCRAFT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-894-8194"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Health System Home Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staples, MN

Sources for this page

Verify at the official NPI Registry.