NPIMap

Organization Active NPI

Lakeview Medical Clinic

  • Clinic/Center
  • Sauk Centre, MN
National Provider Identifier
1831213644
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
1425 Issued in MN
Legal business name
LAKEVIEW MEDICAL CLINIC
Practice address
433 Elm St N
Sauk Centre, MN 56378-1052
Phone
(320) 352-6591
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Authorized official

Name
Dr. Keith J Olson, MDNPI 1790713543
Title
President
Phone
(320) 352-6591

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 1425 MN Primary

Addresses

Primary practice location

433 Elm St N
Sauk Centre, MN 56378-1052

Mailing address

433 Elm Street North
Sauk Centre, MN 56378
Phone (320) 352-6591

Other identifiers 1

IdentifierTypeStateIssuer
54033LAOtherMNBCBS OF MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1831213644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 ELM STREET NORTH",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "56378",
            "telephone_number": "320-352-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 ELM ST N",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "563781052",
            "telephone_number": "320-352-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-352-6591",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "1425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "54033LA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sauk Centre, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.