NPIMap

Organization Active NPI

Lakewood Health Center

Doing business as LakeWood Care Center

  • Skilled Nursing Facility
  • Baudette, MN
National Provider Identifier
1538245386
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
330061 Issued in MN
Legal business name
LAKEWOOD HEALTH CENTER
Doing business as
LakeWood Care Center
Practice address
600 Main Ave S
Baudette, MN 56623-2855
Phone
(218) 634-2120
Fax
(218) 634-1094
NPI assigned
Oct 27, 2006
Last updated
Oct 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Authorized official

Name
Jay Paul Ross
Title
VP Finance
Phone
(218) 616-3525

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 330061 MN
Skilled Nursing Facility 314000000X 330061 MN Primary

Addresses

Primary practice location

600 Main Ave S
Baudette, MN 56623-2855

Mailing address

600 Main Ave S
Baudette, MN 56623-2855
Phone (218) 634-2120

Other names 1

  • LakeWood Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100604000537 MN Part A Provider - Skilled Nursing Facility 5698687929 Practice locations: Baudette, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538245386. Details of each certification follow.

Skilled nursing facility certification: CCN 245580

Legal name
LAKEWOOD HEALTH CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1991
Last certification
Sep 11, 2024
Beds
32
Ownership / control type
Church Related
Multi-facility organization
Common Spirit Health
Organization structure
CorporationNon-profit
Incorporated
Mar 9, 1956 in MN
Enrollment address
600 Main Ave S
Baudette, MN 56623-2855
Nursing home name
LAKEWOOD CARE CENTER
Affiliated entity
COMMONSPIRIT HEALTH

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lakewood Care CenterCCN 245580 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Oct 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3227.7 residents per day on average
Chain
Commonspirit Health18 facilities in the chain
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Lakewood Clinic5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

600 Main Ave S
Birchdale, MN 56623
Phone (218) 634-1655

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Commonspirit Health Organization, Englewood, CO Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 1996 100%
Jeffry a Stampohar Individual Corporate OfficerSite President Jan 15, 2018
W-2 Managing EmployeeSite President Jan 15, 2018
Bradley Nylander Individual Corporate DirectorBoard Vice Chair Mar 1, 2017
Kevin E Lofton Individual Corporate OfficerCorporate Ceo Feb 1, 2019
James Austad Individual Corporate DirectorBoard Jul 1, 2019
Bruce Burton Individual Corporate DirectorBoard Chair Jul 1, 2011
Brent J Schmidt Individual Corporate OfficerDiv Op Oper Finance Jul 1, 2015
W-2 Managing EmployeeDiv VP Oper Finance Jul 1, 2015
Bernice M Ebner Individual Corporate DirectorBoard Jul 1, 2019
Crystal Olson Individual Corporate DirectorBoard Jul 1, 2019
Jeffrey Drop Individual Corporate OfficerFgo Div President Aug 1, 1994
Justin Quo Individual Corporate DirectorBoard Dec 1, 2013

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

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.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1538245386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MAIN AVE S",
            "city": "BAUDETTE",
            "state": "MN",
            "postal_code": "566232855",
            "telephone_number": "218-634-2120",
            "fax_number": "218-634-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAIN AVE S",
            "city": "BAUDETTE",
            "state": "MN",
            "postal_code": "566232855",
            "telephone_number": "218-634-2120",
            "fax_number": "218-634-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "218-616-3525"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MN",
            "license": "330061",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "330061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LakeWood Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baudette, MN

Sources for this page

Verify at the official NPI Registry.