LAKEWALK IMAGING, LLC (NPI# 1164661005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164661005 |
Entity Type | Organization |
Organization Name | LAKEWALK IMAGING, LLC |
Practice Address |
1502 London Road Duluth MN 55812-1788 |
Mailing Address |
1502 London Road Suite 101 Duluth MN 55812-1788 |
Practice Telephone | 2187302165 |
Enumeration Date | 2009-02-17 |
Last Update Date | 2009-02-17 |
Authorized Official Name | DR. ANDREW BAERTSCH (OWNER) |
Authorized Official Telephone | 2187302165 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
Street Address |
1502 LONDON ROAD |
City | DULUTH |
State | MN |
Zip Code | 55812-1788 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124016563 | Christine Aas-larson | Nurse Practitioner | 1502 London Road, Suite 102, Duluth, MN 55812 | 2005-10-10 |
1548516966 | Kristina Louise Borman | Nurse Practitioner | 1502 London Road, Suite 102, Duluth, MN 55812 | 2012-08-03 |
1275767832 | Doreen Marie Wuebkers | Pharmacy Technician | 1502 London Road, Suite 101, Duluth, MN 55812 | 2009-05-12 |
1023033297 | Donald P Gibson | Pharmacist | 1502 London Road, Suite 101, Duluth, MN 55812-2915 | 2006-07-12 |
1164452843 | Firstsolutions | Clinic/Center | 1502 London Road, Suite 102, Duluth, MN 55812-2915 | 2006-07-05 |
1255309738 | Nancy L Rova | Family Medicine | 1502 London Road, 102, Duluth, MN 55812 | 2006-03-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942743950 | Thomas Anthony Olson | Specialist/Technologist | 1049 Ordean Court, 170 Sports & Health Center, Duluth, MN 55812 | 2016-11-22 |
1922457183 | Zen Eye Care Pllc | Optometrist | 2106 London Road, Duluth, MN 55812 | 2016-06-08 |
1295134088 | Charla Buxbaum | Specialist/Technologist | 1216 Ordean Ct. Sphc 170, University of Minnesota Duluth, Duluth, MN 55812 | 2014-08-18 |
1346473998 | Patricia A Trachte | Nurse Practitioner | 107 Ksc, Umd Quick Care, Duluth, MN 55812 | 2009-08-31 |
1003088543 | Arrowhead House Inc | Community Based Residential Treatment Facility, Mental Illness | 16 South 18th Avenue East, Duluth, MN 55812 | 2008-03-25 |
1073689295 | Nicolle Marie Nicklas | Nurse Anesthetist, Certified Registered | 219 Garden St., Duluth, MN 55812 | 2006-11-28 |
1346328762 | Timothy Patrick Stratton | Pharmacist | 386a Kirby Plaza, 1208 Kirby Drive, Duluth, MN 55812 | 2006-11-02 |
1316960701 | Questar Duluth, Inc | Specialist | 1527 London Road, Duluth, MN 55812 | 2006-07-26 |
1063401297 | Clinton T Moen | Specialist | 2711 E 5th St, Duluth, MN 55812 | 2005-10-20 |
1831731645 | Krystal Mueller | Behavior Technician | 1522 E Superior St, Duluth, MN 55812 | 2019-10-14 |
Find all providers in zip 55812 |
Taxonomy Code | 261QR0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Radiology |
Definition to come... |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.