Lakewood Health System
Organization Active NPI Nursing Facility/Intermediate Care Facility · Staples, MN
NPI 1699766733 · NPPES record last updated Jun 9, 2025
Key facts
- NPI
- 1699766733
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- 376427 (MN)
- Legal business name
- LAKEWOOD HEALTH SYSTEM
- Practice address
- 401 Prairie Ave NE
Staples, MN 56479-3201 - Phone
- (218) 894-1515
- Fax
- (218) 898-7596
- NPI assigned
- Oct 28, 2005
- Organization subpart
- No
Authorized official
- Name
- Joseph T Reycraft
- Title
- Cfo
- Phone
- (218) 894-8194
Owners & managing parties with NPI records 5
-
Christine Sara Albrecht, M.D.
-
Ryan David Kray, M.D.
Owned or controlled facilities with NPI records 3
Other NPIs with the same Medicare PAC ID 14
Corporate family (same tax ID) 13
Practitioners 107
-
Christine Sara Albrecht, M.D.
-
Michael Kenneth Hudalla, M.D.
-
Timothy D Aadland, M.D.
-
Jason Elvin Alexander, CRNA
-
Tina Marie Allenburg, NURSE PRACTITIONER
-
Michelle R Allred, CNP
-
Levis Eyo Apana, NP
-
Carissa Arens, APRN, CNP
-
Rebecca Lynn Bennett, PA-C
-
Kalai Ann Brink, AGNP
-
Melissa Ann Buss, PMHNP-BC
-
Jonathan Hal Claussen, M.D.
-
Mark E Colliton, MD
-
Mariah Renae Couture, FNP
-
Paul James Crowe, M.D.
-
Larson Davick, PA-C
-
Paul A Davis, PHD, LP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Skilled nursing facility certification: CCN 245420A
- Legal name
- LAKEWOOD HEALTH SYSTEM
- Organization structure
- Corporation · Non-profit
- Incorporated
- Feb 24, 1997 in MN
- Enrollment address
- 401 Prairie Ave NE
Staples, MN 56479-3201 - Nursing home name
- LAKEWOOD HEALTH SYSTEM
All disclosed owners & managing parties 33
| Name | Role | Since | Share |
|---|---|---|---|
| Melissa Beth Lindow |
Operational/Managerial Control |
Aug 27, 2023 | |
| Billy Joe Haehnel |
Corporate Director |
Nov 1, 2015 | |
| Joseph Thomas Reycraft |
Corporate Officer |
Aug 28, 2022 | |
| Operational/Managerial Control |
Aug 28, 2022 | ||
| Curtis Eugene McIlravy |
Corporate Officer |
Jul 1, 2014 | |
| Ryan David Kray |
Corporate Director |
Oct 1, 2021 | |
| Robert Michael Mueller |
Corporate Director |
Jun 25, 2015 | |
| Sara Jane Grove |
Corporate Director |
Apr 24, 2014 | |
| Craig Thomas Wolhowe |
Corporate Officer |
Jun 11, 1997 | |
| Operational/Managerial Control |
Jun 11, 1997 | ||
| Alicia Kay Bauman |
Operational/Managerial Control |
Oct 9, 2022 | |
| Mary Martha Theurer |
Corporate Officer |
Jan 1, 2010 | |
| Elizabeth Ann Pottratz |
Corporate Director |
Jan 1, 2023 | |
| Lisa Marie Bjerga |
Corporate Officer |
Mar 7, 2016 | |
| Operational/Managerial Control |
Mar 7, 2016 | ||
| Kaitlyn Rose Schoeck |
Corporate Director |
Aug 7, 2017 | |
| Lana Ellen Hansen |
Corporate Director |
Jan 1, 2008 | |
| Ronald Alvin Storbakken |
Corporate Director |
Jan 1, 2000 | |
| Kevin Lee Nelson |
Corporate Director |
Apr 1, 2018 | |
| Kathleen Marie Dobson |
Operational/Managerial Control |
Dec 1, 2014 | |
| Judith Ann Bjerga |
Corporate Director |
Jan 1, 2007 | |
| James Alan Roeder |
Operational/Managerial Control |
Oct 15, 2017 | |
| Brad Richard Anderson |
Operational/Managerial Control |
Aug 13, 2014 | |
| Amy Jo Brichacek |
Corporate Director |
Jan 1, 2021 | |
| Emil Paul Wicht |
Corporate Director |
Jan 1, 1973 | |
| Corrine Marie Neisess |
Operational/Managerial Control |
Sep 1, 2018 | |
| Melissa Sue Daniels |
W-2 Managing Employee |
Sep 15, 2016 | |
| Norman Harold Krause |
Corporate Director |
Jul 1, 2018 | |
| Susan Kay Peet |
Corporate Director |
Jan 1, 2021 | |
| Wade Thomas Swenson |
Corporate Director |
Jan 1, 2023 | |
| Lindsay Rae Leveille |
Corporate Director |
Jul 1, 2023 | |
| Stephanie Marie Jordahl |
Corporate Director |
Jul 1, 2021 | |
| Christine Sara Albrecht |
Operational/Managerial Control |
Jun 1, 2020 | |
| Lynn Marie Newton Rice |
Operational/Managerial Control |
Jun 30, 1980 | |
| Beverly Jean Hoemberg |
Corporate Director |
Jan 1, 2011 | |
| Jef Richard Cichos |
Corporate Director |
Jul 1, 2016 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Lakewood Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest General Partnership Interest |
Apr 1, 1997 Apr 1, 1997 |
| Lakewood Clinic-Browerville |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 1997 |
| Lakewood Clinic-Pillager |
Rural health clinic | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Mar 1, 1998 Mar 1, 1998 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130627000386 | MN | Part a Provider - Skilled Nursing Facility | 1052229671 | Practice locations: Staples, MN |
National Provider Directory
- Tax ID family
- Lakewood Clinic Staples
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 376427 | MN | Yes |
Addresses
Primary practice location
401 Prairie Ave NE
Staples, MN 56479-3201
Mailing address
401 Prairie Ave NE
Staples, MN 56479-3201
Phone (218) 894-1515
Other providers in Staples, MN
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- Mary J Lamusga
All providers in Staples, MN · Nursing Facility/Intermediate Care Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.