NPIMap

Organization Active NPI

Lakes Regional Healthcare

Doing business as Avera Medical Group-Spirit Lake Medical Center a Department of Lakes

  • Clinic/Center
  • Spirit Lake, IA
National Provider Identifier
1609121896
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LAKES REGIONAL HEALTHCARE
Doing business as
Avera Medical Group-Spirit Lake Medical Center a Department of Lakes
Practice address
2700 23Rd St
Spirit Lake, IA 51360
Phone
(712) 336-2410
Fax
(712) 336-3241
NPI assigned
Jul 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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
Clinic/Center 261Q00000X IA Primary

Addresses

Primary practice location

2700 23Rd St
Spirit Lake, IA 51360

Mailing address

2700 23Rd St
Spirit Lake, IA 51360-1158
Phone (712) 336-2410

Other names 1

  • Avera Medical Group-Spirit Lake Medical Center a Department of Lakes 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

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536278400000",
    "number": "1609121896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 23RD ST",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "513601158",
            "telephone_number": "712-336-2410",
            "fax_number": "712-336-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 23RD ST",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "51360",
            "telephone_number": "712-336-2410",
            "fax_number": "712-336-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES REGIONAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-13",
        "last_updated": "2018-09-07",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group-Spirit Lake Medical Center a Department of Lakes",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Medical Group-Spirit Lake Medical Center a Department of Lakes",
            "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 Sep 7, 2018; 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.