NPIMap

Organization Active NPI

Lakewood Health Center

Doing business as CHI Lakewood Health

  • Rural Health Clinic/Center
  • Baudette, MN
National Provider Identifier
1659511335
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LAKEWOOD HEALTH CENTER
Doing business as
CHI Lakewood Health
LakeWood Health Center RHC
Practice address
600 Main Ave S
Baudette, MN 56623-2855
Phone
(218) 634-1655
Fax
(218) 634-1094
NPI assigned
Feb 20, 2009
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU 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) 634-1655

Other names 2

  • CHI Lakewood Health Doing business as
  • LakeWood Health Center RHC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101103000413 MN Part A Provider - Rural Health Clinic 5698687929 Practice locations: Baudette, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659511335. Details of each certification follow.

Rural health clinic certification: CCN 243450

Legal name
LAKEWOOD HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 12, 2010
Last certification
Aug 4, 2015
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Sep 9, 1956 in MN
Enrollment address
600 Main Ave S
Baudette, MN 56623-2855
Related CCNs
241301

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Lakewood Health Center5 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

3470 Solutions Ctr
Chicago, IL 60677

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 Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 21, 2011 100%
Jeffry a Stampohar Individual Corporate OfficerSite President Jan 15, 2018
W-2 Managing EmployeeSite President Jan 15, 2018
Lloyd H Dean Individual Corporate DirectorOrganization President & Ceo Jun 1, 2000
Bradley Nylander Individual Corporate DirectorBoard Vice Chair May 1, 2017
Amber G Stowman Individual Corporate OfficerDiv VP of Operational Finance Aug 12, 2018
W-2 Managing EmployeeDiv VP of Operational Finance Aug 12, 2018
Jay Paul Ross Individual Corporate Officer Jul 1, 2015
W-2 Managing Employee Jul 1, 2015
James Austad Individual Corporate DirectorBoard Jul 1, 2019
Bruce Burton Individual Corporate DirectorBoard Chair Apr 2, 2015
Brent J Schmidt Individual Corporate OfficerDiv VP Oper Finance Jul 1, 2015
W-2 Managing EmployeeDiv VP Oper Finance Jul 1, 2015
Bernice M Ebner Individual Corporate DirectorBoard Jul 1, 2019
Justin Quo Individual Corporate DirectorBoard Apr 2, 2015

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1659511335",
    "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": "218-634-1655",
            "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": "218-634-1655",
            "fax_number": "218-634-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-20",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI Lakewood Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LakeWood Health Center RHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baudette, MN

Sources for this page

Verify at the official NPI Registry.