NPIMap

Organization Active NPI

Lakes Regional Healthcare

  • Community Based Hospice Care Agency
  • Milford, IA
National Provider Identifier
1972566875
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
300028H Issued in IA
Legal business name
LAKES REGIONAL HEALTHCARE
Practice address
1003 21St Street
Milford, IA 51351
Phone
(712) 338-9998
Fax
(712) 338-9990
NPI assigned
Apr 11, 2006
Last updated
Sep 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Authorized official

Name
Mr. Steven J Alger
Title
Sr VP and Cfo
Phone
(712) 336-8796

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 300028H IA Primary

Addresses

Primary practice location

1003 21St Street
Milford, IA 51351

Mailing address

1003 21St Street
Milford, IA 51351
Phone (712) 338-9998

Other identifiers 1

IdentifierTypeStateIssuer
0615666MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040402001262 IA Part A Provider - Hospice 0941118442 Practice locations: Spirit Lake, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972566875. Details of each certification follow.

Hospice certification: CCN 161562

Legal name
LAKES REGIONAL HEALTHCARE
Doing business as
LAKES REGIONAL HEALTHCARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 2, 1999
Last certification
Apr 7, 2022
Ownership / control type
Government - County
Organization structure
GovernmentNon-profit
Enrollment address
2301 Highway 71
Spirit Lake, IA 51360-1253

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Lakes Regional Healthcare HospiceCCN 161562 · All quality measures
Ownership
Government
Certified
Dec 2, 1999
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Lakes Regional Healthcare11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nate McCormick Individual Corporate OfficerVP Ancillary & Community Services May 25, 2020
Dan L Sedlacek Individual Corporate Director Mar 26, 2007
Lakes Regional Healthcare Organization, Spirit Lake, IA Other Jan 1, 1966 100%
Jason Charles Harrington Individual Corporate DirectorPresident and Ceo Jul 1, 2009 100%
Kristine a. Walker Individual Corporate Director Jan 7, 2008
Steven J Alger Individual Corporate OfficerSr Vice President and Cfo May 3, 2011
W-2 Managing Employee Nov 2, 2010
Jill R. Christoffels Individual W-2 Managing EmployeeDirector of Hospice Oct 11, 2019
Denny L. Perry Individual Corporate Director Jan 7, 2008
Jennifer H. Gustafson Individual W-2 Managing Employee Jan 7, 2008

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536278400000",
    "number": "1972566875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 21ST STREET",
            "city": "MILFORD",
            "state": "IA",
            "postal_code": "51351",
            "telephone_number": "712-338-9998",
            "fax_number": "712-338-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 21ST STREET",
            "city": "MILFORD",
            "state": "IA",
            "postal_code": "51351",
            "telephone_number": "712-338-9998",
            "fax_number": "712-338-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES REGIONAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2018-09-07",
        "status": "A",
        "authorized_official_last_name": "ALGER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR VP AND CFO",
        "authorized_official_telephone_number": "712-336-8796",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IA",
            "license": "300028H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0615666",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, IA

Sources for this page

Verify at the official NPI Registry.