NPIMap

Organization Active NPI

Lake Region Healthcare Corporation

  • Non-Pharmacy Dispensing Site
  • Elbow Lake, MN
National Provider Identifier
1902449309
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
LAKE REGION HEALTHCARE CORPORATION
Practice address
1411 Highway 79 E
Elbow Lake, MN 56531-4645
Phone
(952) 653-2565
Fax
(952) 653-2540
NPI assigned
Oct 18, 2019
Last updated
Jul 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Chris Johnson
Title
Cfo
Phone
(218) 736-8687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

1411 Highway 79 E
Elbow Lake, MN 56531-4645

Mailing address

1411 Highway 79 E
Elbow Lake, MN 56531-4645
Phone (218) 685-7300

National Provider Directory

National Provider Directory
Tax ID family
Lake Region Healthcare Corporation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1902449309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 HIGHWAY 79 E",
            "city": "ELBOW LAKE",
            "state": "MN",
            "postal_code": "565314645",
            "telephone_number": "218-685-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 HIGHWAY 79 E",
            "city": "ELBOW LAKE",
            "state": "MN",
            "postal_code": "565314645",
            "telephone_number": "952-653-2565",
            "fax_number": "952-653-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGION HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-736-8687"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elbow Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.