ESSENTIA HEALTH LAKEWALK CLINIC
NPI 1275839193
Clinic/Center - Multi-Specialty in Duluth, MN

NPI Status: Active since February 10, 2011

Contact Information

1502 LONDON RD STE 102
DULUTH, MN
ZIP 55812
Phone: (218) 576-0100
Fax: (218) 576-0126

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  • Organization
  • Clinic/Center
  • Multi-Specialty
  • Accepts Insurance
  • CLIA Number: 24D0404121
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-30-2027

About ESSENTIA HEALTH LAKEWALK CLINIC

This page provides the complete NPI Profile along with additional information for Essentia Health Lakewalk Clinic, a provider established in Duluth, Minnesota operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1275839193 assigned on February 2011. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Essentia Health Lakewalk Clinic. The authorized official of this NPI record is Kevin Boren (Vp Of Finance)

NPI
1275839193
Provider Legal Name
THE DULUTH CLINIC, LTD
Other Organization Name
ESSENTIA HEALTH LAKEWALK CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1502 LONDON RD STE 102 DULUTH, MN 55812
Location Phone
(218) 576-0100
Location Fax
(218) 576-0126
Mailing Address
1502 LONDON RD STE 102 DULUTH, MN 55812
Mailing Phone
(218) 576-0100
Mailing Fax
(218) 576-0126
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
02-10-2011
Last Update Date
02-28-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Atlas $1,300 Gold - PPO
  • Atlas $2,000 Standard Gold - PPO
  • Atlas $3,050 Plus Silver - PPO
  • Atlas $3,800 HSA Silver - PPO
  • Atlas $6,000 Standard Silver - PPO
  • Atlas $6,800 Plus Bronze HSA - PPO
  • Atlas $7,500 Standard Bronze HSA - PPO
  • Atlas $8,400 HSA Bronze - PPO
  • Essentia Choice Care with Medica Bronze HSA - EPO
  • Essentia Choice Care with Medica Bronze Share - EPO
  • Essentia Choice Care with Medica Expanded Bronze Standard - EPO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Gold Share - EPO
  • Essentia Choice Care with Medica Gold Standard - EPO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Silver Share - EPO
  • Essentia Choice Care with Medica Silver Standard - EPO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Sanford Individual Simplicity $1,750 - PPO
  • Sanford Individual Simplicity $10,600 - PPO
  • Sanford Individual Simplicity $3,500 - PPO
  • Sanford Individual Simplicity $4,750 - PPO
  • Sanford Individual Simplicity $6,500 - PPO
  • Sanford Individual Simplicity $7,200 HSA Qualified - PPO
  • Sanford Individual Simplicity Standardized $2,000 - PPO
  • Sanford Individual Simplicity Standardized $6,000 - PPO
  • Sanford Individual Simplicity Standardized $7,500 - PPO
  • Premier $2,000 - 25% - HMO
  • Premier $3,500 - 30% - HMO
  • Premier $4,000 - 50% - HMO
  • Premier $5,000 HDHP - HMO
  • Premier $6,000 - 40% - HMO
  • Premier $7,500 - HMO
  • Premier $7,500 HDHP - HMO
  • Select $2,000 - 25% - EPO
  • Select $3,500 - 30% - EPO
  • Select $4,000 - 50% - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KEVIN BOREN

Authorized Official Title
VP OF FINANCE
Authorized Official Phone
(218) 786-1009

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1275839193MEDICAID (05)MN 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D0404121
Facility Type
Physician Office
Certificate Effective Date
October 01, 2025
Certificate Expiration Date
September 30, 2027
Laboratory Director
SANDRA MATTSON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Essentia Health Lakewalk Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1275839193, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
3
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
1
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 8 → 16 → 7 9 → 18 → 9 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 1 + 6 + 3 + 1 + 8 + 1 + 1 + 8 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1275839193.

Other Providers at the Same Location


The following 13 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
1502 LONDON RD STE 102, ESSENTIA HEALTH LAKEWALK CLINIC
DULUTH, MN 55812
Occupational Therapist
1502 LONDON RD STE 102, ESSENTIA HEALTH LAKEWALK CLINIC
DULUTH, MN 55812
Nurse Practitioner (Family)
1502 LONDON RD STE 102
DULUTH, MN 55812
Nurse Practitioner (Family)
1502 LONDON RD STE 102
DULUTH, MN 55812
Clinical Neuropsychologist
1502 LONDON RD STE 102
DULUTH, MN 55812
Nurse Practitioner (Family)
1502 LONDON RD STE 102
DULUTH, MN 55812
Physician Assistant
1502 LONDON RD STE 102
DULUTH, MN 55812
Family Medicine
1502 LONDON RD STE 102
DULUTH, MN 55812
Physical Medicine & Rehabilitation
1502 LONDON RD STE 102
DULUTH, MN 55812
Clinical Neuropsychologist
1502 LONDON RD STE 102
DULUTH, MN 55812
Physician Assistant
1502 LONDON RD STE 102
DULUTH, MN 55812
Physician Assistant
1502 LONDON RD STE 102
DULUTH, MN 55812
Family Medicine
1502 LONDON RD STE 102
DULUTH, MN 55812

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275839193, enumerated as an "organization" on February 10, 2011.

The provider is located at 1502 LONDON RD STE 102 DULUTH, MN 55812 and the phone number is (218) 576-0100.

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.

The provider might be accepting Accepts: HealthPartners, Medica, Sanford Health Plan,. Please consult your insurance carrier or call the provider to verify.