NPIMap

Organization Active NPI

Lakewood Health System

  • Durable Medical Equipment & Medical Supplies
  • Long Prairie, MN
National Provider Identifier
1891131058
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LAKEWOOD HEALTH SYSTEM
Practice address
221 Lake St S
Suite 102
Long Prairie, MN 56347-7121
Phone
(320) 732-3051
Fax
(320) 732-6105
NPI assigned
May 15, 2013
Last updated
Jun 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Joseph T Reycraft
Title
Cfo
Phone
(218) 894-8194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

221 Lake St S
Suite 102
Long Prairie, MN 56347-7121

Mailing address

49725 County 83
Staples, MN 56479-5280
Phone (218) 894-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140210001202 MN DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & EquipmentDME Supplier - Medical Supply Company With Prosthetic Personnel 1052229671 Practice locations: Long Prairie, MN

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Lakewood Health System221 Lake Street South, Long Prairie, MN 56347-7122(320) 732-3051 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Negative Pressure Wound Therapy Pumps/Supplies|Neuromuscular Elect Stimulators (NMES)/Supplies|Pneumatic Compression Devices and/or Supplies|Support S… Accepts assignmentParticipating since Jan 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
North Memorial Health Care14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

221 Lake St S
Ste 102
Long Prairie, MN 56347
Phone (320) 732-3051

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lakewood ClinicStaples, MN, CCN 243422 Rural health clinic 5% Or Greater Direct Ownership Interest
General Partnership Interest		 Apr 1, 1997
Apr 1, 1997
Lakewood Clinic-BrowervilleEagle Bend, MN, CCN 243421 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1997
Lakewood Clinic-PillagerPillager, MN, CCN 243436 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Mar 1, 1998
Mar 1, 1998

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Lakewood Health System

    dba Lakewood Clinic Eagle Bend

    • Rural Health Clinic/Center
    • Eagle Bend, MN
    • NPI 1093706160

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Lakewood Health System

    dba Lakewood Clinic Pillager

    • Rural Health Clinic/Center
    • Pillager, MN
    • NPI 1811988983

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Lakewood Health System

    dba Lakewood Clinic Staples

    • Rural Health Clinic/Center
    • Staples, MN
    • NPI 1841280823

    5% Or Greater Direct Ownership Interest, General Partnership Interest

    CMS ownership

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1891131058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-898-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 LAKE ST S",
            "address_2": "SUITE 102",
            "city": "LONG PRAIRIE",
            "state": "MN",
            "postal_code": "563477121",
            "telephone_number": "320-732-3051",
            "fax_number": "320-732-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "REYCRAFT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-894-8194"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Prairie, MN

Sources for this page

Verify at the official NPI Registry.