| Lake View Memorial Hospital, Inc | |
|
325 11th Ave Two Harbors MN 55616-1300 | |
| (218) 834-7300 | |
| (218) 834-7388 |
| Full Name | Lake View Memorial Hospital, Inc |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 325 11th Ave, Two Harbors, Minnesota |
| Authorized Official Name and Position | Jerry Yang (SVP & CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7158472526 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake View Memorial Hospital, Inc 29980 Network Pl Chicago IL 60673-1299 Ph: (218) 834-7300 | Lake View Memorial Hospital, Inc 325 11th Ave Two Harbors MN 55616-1300 Ph: (218) 834-7300 |
| NPI Number | 1023067642 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 05/06/2025 |
| Medicare PECOS PAC ID | 9032002688 |
|---|---|
| Medicare Enrollment ID | O20040206000105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023067642 | NPI | - | NPPES |
| 739045900 | Medicaid | MN | |
| 1886HLA | Other | MN | BLUE CROSS MINNESOTA |
| 2718 | Other | HEALTHPARTNERS | |
| 5000116 | Other | MEDICA | |
| UCARE | Other | MN | UCARE MINNESOTA |
| 01016526 | Other | MN | PREFERRED ONE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 282NC0060X | General Acute Care Hospital - Critical Access | 331064 (Minnesota) | Primary |
| Provider Name | Randy J Rice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083652275 PECOS PAC ID: 3577468719 Enrollment ID: I20031202000089 |
| Provider Name | Brigid M Pajunen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386627172 PECOS PAC ID: 3274434196 Enrollment ID: I20040115000054 |
| Provider Name | John J Baga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770577033 PECOS PAC ID: 0143217703 Enrollment ID: I20040427000894 |
| Provider Name | Paul M Mccormick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275581340 PECOS PAC ID: 6709874910 Enrollment ID: I20040505001067 |
| Provider Name | James B Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336191030 PECOS PAC ID: 3678556594 Enrollment ID: I20040611000142 |
| Provider Name | Karen Ruth Ginn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619080496 PECOS PAC ID: 9133102833 Enrollment ID: I20040612000048 |
| Provider Name | Kevin Michael Brady |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528002045 PECOS PAC ID: 3678553682 Enrollment ID: I20040721000914 |
| Provider Name | Carmen L Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770524258 PECOS PAC ID: 8224009790 Enrollment ID: I20040805001518 |
| Provider Name | Howard Y Josephs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033144894 PECOS PAC ID: 0042225559 Enrollment ID: I20060220000306 |
| Provider Name | Shawn P Mcmahon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871528646 PECOS PAC ID: 4789586439 Enrollment ID: I20060220000338 |
| Provider Name | Robert J Zeleznikar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417923194 PECOS PAC ID: 4284642398 Enrollment ID: I20060331000319 |
| Provider Name | Elizabeth M Godin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780798207 PECOS PAC ID: 7214947340 Enrollment ID: I20060503000431 |
| Provider Name | Nichole M Schaefer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649220641 PECOS PAC ID: 7719984673 Enrollment ID: I20070111000457 |
| Provider Name | Ross L Peterson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982756177 PECOS PAC ID: 6608878848 Enrollment ID: I20070201000135 |
| Provider Name | Eric J Ringsred |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821013376 PECOS PAC ID: 8820193683 Enrollment ID: I20070424000125 |
| Provider Name | Matthew John Dammeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083838403 PECOS PAC ID: 8921177114 Enrollment ID: I20090826000426 |
| Provider Name | Addie C Vittorio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225205149 PECOS PAC ID: 2466485875 Enrollment ID: I20091001000162 |
| Provider Name | Timothy C Kleinschmidt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245280601 PECOS PAC ID: 4981688553 Enrollment ID: I20091230000162 |
| Provider Name | James Q Donovan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568413078 PECOS PAC ID: 6103967344 Enrollment ID: I20100109000164 |
| Provider Name | Scott I Halvorson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003145426 PECOS PAC ID: 7719022136 Enrollment ID: I20100309000626 |
| Provider Name | Stephen Monroe Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326238338 PECOS PAC ID: 4981732567 Enrollment ID: I20100503000771 |
| Provider Name | Annette C Schmit-cline |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790753911 PECOS PAC ID: 9537243126 Enrollment ID: I20100924000399 |
| Provider Name | Doron M Spierer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356654388 PECOS PAC ID: 1456547561 Enrollment ID: I20101130001425 |
| Provider Name | Anthony D Mullozzi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649580366 PECOS PAC ID: 8729260948 Enrollment ID: I20110309000836 |
| Provider Name | Jennifer L Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326348848 PECOS PAC ID: 0446432173 Enrollment ID: I20110316000669 |
| Provider Name | Laura A Hase |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992097844 PECOS PAC ID: 7719133883 Enrollment ID: I20120804000099 |
| Provider Name | Cassandra J Morsette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497003958 PECOS PAC ID: 4385896174 Enrollment ID: I20121129000622 |
| Provider Name | Nathan Opland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639590102 PECOS PAC ID: 6103056346 Enrollment ID: I20140307001281 |
| Provider Name | Kelsey M Schultz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578827150 PECOS PAC ID: 8123262037 Enrollment ID: I20150728006482 |
| Provider Name | Sarah J Nord |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316313927 PECOS PAC ID: 8022325554 Enrollment ID: I20150916002037 |
| Provider Name | Robert Maurice Payne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184038580 PECOS PAC ID: 3476857798 Enrollment ID: I20170524000107 |
| Provider Name | Chunyen Liu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841604485 PECOS PAC ID: 9739451857 Enrollment ID: I20170823003543 |
| Provider Name | Ronald E Carroll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790821122 PECOS PAC ID: 7315998226 Enrollment ID: I20180530002452 |
| Provider Name | Eric T Hanhan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245688878 PECOS PAC ID: 9032401526 Enrollment ID: I20180718003193 |
| Provider Name | Brittni J Mclam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821484957 PECOS PAC ID: 5698079788 Enrollment ID: I20180830002343 |
| Provider Name | Elizabeth A Feist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730536590 PECOS PAC ID: 2668764705 Enrollment ID: I20181030001038 |
| Provider Name | Charles P Tabor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740719640 PECOS PAC ID: 2163756214 Enrollment ID: I20190625000312 |
| Provider Name | Benjamin W Dummer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710416706 PECOS PAC ID: 8123353208 Enrollment ID: I20190711001503 |
| Provider Name | Amy J Suomi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205498631 PECOS PAC ID: 0143551085 Enrollment ID: I20191008001903 |
| Provider Name | Imtiaz Mohamed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396796884 PECOS PAC ID: 9739197534 Enrollment ID: I20200930000240 |
| Provider Name | Blake S Chapman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205324209 PECOS PAC ID: 6507113289 Enrollment ID: I20210709002122 |
| Provider Name | Trevor Diercks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952864076 PECOS PAC ID: 7012241797 Enrollment ID: I20220906001556 |
| Provider Name | Ethan Edward Burlingame |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457926842 PECOS PAC ID: 8426451444 Enrollment ID: I20221024000550 |
| Provider Name | Lucas T Henningsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164045647 PECOS PAC ID: 2860814449 Enrollment ID: I20230911002493 |
| Provider Name | John Hugh Granville Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992325476 PECOS PAC ID: 5698140853 Enrollment ID: I20240514002098 |
Firstsolutions Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 4th St, Two Harbors, MN 55616 Phone: 218-834-7200 Fax: 218-834-7220 | |
St. Luke's Hospital Of Duluth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 11th Ave, Two Harbors, MN 55616 Phone: 218-834-7700 | |
Premise Health Of Minnesota Medical P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 709 23rd Ave, Two Harbors, MN 55616 Phone: 218-510-6001 | |
Lake View Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 11th Ave, Two Harbors, MN 55616 Phone: 218-834-7200 Fax: 218-834-7220 | |
Lake View Memorial Hospital, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 11th Ave, Two Harbors, MN 55616 Phone: 218-834-7300 Fax: 218-834-7388 |