Twin Lakes Primary Care Services, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

TWIN LAKES PRIMARY CARE SERVICES, LLC

Practice address

20399 Turtle River Lake Rd NE
Hines, MN 56647-5742

Phone

(218) 368-2093

NPI assigned

May 30, 2019

Last updated

May 30, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jill Cease, CNPNPI 1245284249

Title

Owner/Provider

Phone

(218) 368-2093

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

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.

• Jill Suzanne Cease, CNP

  • Family Nurse Practitioner
  • Hines, MN
  • NPI 1245284249
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1710545264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20399 TURTLE RIVER LAKE RD NE",
            "city": "HINES",
            "state": "MN",
            "postal_code": "566475742",
            "telephone_number": "218-368-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20399 TURTLE RIVER LAKE RD NE",
            "city": "HINES",
            "state": "MN",
            "postal_code": "566475742",
            "telephone_number": "218-368-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN LAKES PRIMARY CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "CEASE",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "218-368-2093",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Suzanne Cease, CNP
• Ruth Elizabeth Eckstrom, NP-C

• Clinic/Center in Hines, MN
• Providers in Hines, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.