Lakeville Integrative Medicine Clinic

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

31345 Issued in MN

Legal business name

LAKEVILLE INTEGRATIVE MEDICINE CLINIC

Doing business as

Lakeville Integrative Medicine Clinic

Practice address

16372 Kenrick Ave
Suite 100
Lakeville, MN 55044-3540

Phone

(952) 892-6700

Fax

(952) 892-9475

NPI assigned

Mar 15, 2007

Last updated

Aug 22, 2020By 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

Dr. Mark D Rieb, MD, NMD

Title

Ceo

Phone

(952) 892-6700

Specialties & licenses 1

Addresses

Other names 1

• Lakeville Integrative Medicine Clinic Doing business as

Locations

Practitioners 2

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.

• Mahmood Ameli, DC DACAN

  • Chiropractor
  • Lakeville, MN
  • NPI 1346280781
  NPD (past)
• Laura Jarvis, PA-C

  • Physician Assistant
  • Saint Paul, MN
  • NPI 1053390815
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851425227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16372 KENRICK AVE",
            "address_2": "SUITE 100",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443540",
            "telephone_number": "952-892-6700",
            "fax_number": "952-892-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16372 KENRICK AVE",
            "address_2": "SUITE 100",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443540",
            "telephone_number": "952-892-6700",
            "fax_number": "952-892-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVILLE INTEGRATIVE MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIEB",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-892-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, NMD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MN",
            "license": "31345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeville Integrative Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lakeville Family Eye Care LLC
• Lakeville Family Health Clinic, LTD
• Lakeville Family Therapy
• Lakeville Foot and Ankle Practice PLLC
• Lakeville Integrated Health Clinic Inc.
• Lakeville Modern Dentistry, PLLC
• Lakeville Orthodontic Associates LLC
• Lakeville Relief Care
• Lakeville Snyder Drug
• Debra J Lakin, RPH

• Medical Specialty Clinic/Center in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Medical Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.