GAYLORD LAKEVIEW HOME (NPI# 1750388336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750388336 |
| Entity Type | Organization |
| Organization Name | GAYLORD LAKEVIEW HOME |
| Practice Address |
640 3rd St Gaylord MN 55334-2297 |
| Practice Telephone | 5072372911 |
| Practice Fax Number | 5072375744 |
| Mailing Telephone | 5072372911 |
| Mailing Fax Number | 5072375744 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2007-07-16 |
| Authorized Official Name | MARY NELL ZELLNER (ADMINISTRATOR) |
| Authorized Official Telephone | 5072372911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 318160 | MN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICA | 71-22555 | 01 |
| MN | BLUE CROSS BLUE SHIELD | 9711LA | 01 |
| Street Address |
640 3RD ST |
| City | GAYLORD |
| State | MN |
| Zip Code | 55334-2297 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356972236 | Jenna M Krautkremer | Physical Therapy Assistant | 640 3rd St, Gaylord, MN 55334-2297 | 2020-01-30 |
| 1033670435 | Anila Sharma | Physical Therapist | 640 3rd St, Gaylord, MN 55334-2297 | 2019-03-27 |
| 1417470048 | Teresa Ann Burmis | Physical Therapy Assistant | 640 3rd St, Gaylord, MN 55334-2297 | 2017-07-25 |
| 1700308145 | Angela Rose Hoff | Occupational Therapist | 640 3rd St, Gaylord, MN 55334-2297 | 2017-07-07 |
| 1902340193 | Geri Loose | Physical Therapy Assistant | 640 3rd St, Gaylord, MN 55334-2297 | 2016-12-07 |
| 1457726515 | Karen Hammond | Speech-Language Pathologist | 640 3rd St, Gaylord, MN 55334-2297 | 2015-12-01 |
| 1073933248 | Kristin Elizabeth Berndt | Speech-Language Pathologist | 640 3rd St, Gaylord, MN 55334-2297 | 2014-04-25 |
| 1598180366 | Jaime Petersen | Occupational Therapist | 640 3rd St, Gaylord, MN 55334-2297 | 2014-03-03 |
| 1639503980 | Ashley Maria Engles | Speech-Language Pathologist | 640 3rd St, Gaylord, MN 55334-2297 | 2013-08-22 |
| 1750625265 | Staci Brandt | Physical Therapist | 640 3rd St, Gaylord, MN 55334-2297 | 2012-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396030615 | Cassandra Dee Mcguire | Chiropractor | 215 3rd St, Gaylord, MN 55334 | 2011-06-15 |
| 1346389111 | Ronald Allen Reinmuth | Dentist | 112 3rd St, Gaylord, MN 55334 | 2007-02-06 |
| 1396818175 | County of Sibley | Clinic/Center | 111 8th Street, Gaylord, MN 55334 | 2006-11-17 |
| 1376633743 | Addiction Counseling Treatment Services | Counselor | 112 5th St., Gaylord, MN 55334 | 2006-10-13 |
| 1871553289 | Sibley Medical Center | Clinic/Center | 660 3rd Street, Gaylord, MN 55334 | 2006-03-28 |
| 1659873420 | Restore Chiropractic and Wellness LLC | Chiropractor | 215 3rd St, Gaylord, MN 55334 | 2018-03-07 |
| 1760763007 | Mcguire Family Chiropractic Pa | Chiropractor | 215 3rd St, Gaylord, MN 55334 | 2011-08-31 |
| 1629109632 | Todd Mcgillick | Chiropractor | 311 5th St, Gaylord, MN 55334 | 2007-03-08 |
| 1811162829 | Gaylord Dental Inc | Dentist | Fourth Street, 312, Gaylord, MN 55334-0093 | 2008-04-30 |
| 1710212055 | County of Sibley | Public Health or Welfare | 111 8th St, Gaylord, MN 55334-0237 | 2009-10-05 |
| Find all providers in zip 55334 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366802811 | Susan Spurgeon | Skilled Nursing Facility | 303 N Center Ave, Gaylord, MI 49735-1477 | 2016-02-26 |
| 1154848224 | Gaylord Opco, LLC | Skilled Nursing Facility | 508 Random Ln, Gaylord, MI 49735-9304 | 2017-08-29 |
| 1215453691 | Gaylord Opco, LLC | Skilled Nursing Facility | 508 Random Ln, Gaylord, MI 49735-9304 | 2017-08-17 |
| 1245602754 | Shawna Elizabeth Butler | Skilled Nursing Facility | 508 Random Ln, Gaylord, MI 49735-9304 | 2015-10-23 |
| 1629452214 | Fmg Random Lane Michigan LLC | Skilled Nursing Facility | 508 Random Ln, Gaylord, MI 49735-9304 | 2015-07-14 |
| 1831597285 | Fmg Random Lane Michigan LLC | Skilled Nursing Facility | 508 Random Ln, Gaylord, MI 49735-9304 | 2014-12-17 |
| 1285820092 | Oak Terrace Health Care Center of Gaylord,llc | Skilled Nursing Facility | 640 3rd St, Gaylord, MN 55334-2297 | 2007-09-15 |
| 1053428052 | Tendercare Select Properties Inc. | Skilled Nursing Facility | 508 Random Ln, Rte. 1, Gaylord, MI 49735-9304 | 2006-08-24 |
| 1598700403 | Tendercare Select Properties Inc. | Skilled Nursing Facility | 508 Random Ln, Rte. 4, Gaylord, MI 49735-9304 | 2006-06-17 |
| 1851341333 | Munson Healthcare Otsego Memorial Hospital | Skilled Nursing Facility | 825 N Center Ave, Gaylord, MI 49735 | 2006-05-12 |
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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.