Light Mountain Healthworks Inc.

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

R107370-6 Issued in MN

Legal business name

LIGHT MOUNTAIN HEALTHWORKS INC.

Practice address

502 Hidden Trail CT SW
Bemidji, MN 56601-2569

Phone

(218) 759-0835

Fax

(218) 759-0835

NPI assigned

Apr 10, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Janet Ann Listebarger, RN, MT

Title

President

Phone

(218) 759-0835

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1302393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302393600000",
    "number": "1780974998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 HIDDEN TRAIL CT SW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012569",
            "telephone_number": "218-759-0835",
            "fax_number": "218-759-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 HIDDEN TRAIL CT SW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012569",
            "telephone_number": "218-759-0835",
            "fax_number": "218-759-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT MOUNTAIN HEALTHWORKS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-10",
        "last_updated": "2011-04-10",
        "status": "A",
        "authorized_official_last_name": "LISTEBARGER",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-759-0835",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MT"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "MN",
            "license": "R107370-6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alvaro Lewis Ramos, MD
• Matthew J Liapis
• Sydney Lichty, SLP
• Brian Alan Lietz, BA
• Life Quest Chiropractic Center Bemidji PC
• Stephanie Lind, RN
• Tessa Lindberg, OTR/L
• Lindell Consulting, LLC
• Tami Dawn Lindell, DNP, FNP, GNP, PMHNP
• Jill Lindholm, LADC

• Pain Clinic/Center in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Pain Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.