ESSENTIA HEALTH ST. MARY'S - LAKE PARK CLINIC
NPI 1548604309
Family Medicine in Lake Park, MN

NPI Status: Active since April 24, 2013

Contact Information

1005 1ST ST
LAKE PARK, MN
ZIP 56554
Phone: (218) 238-5901

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  • Organization
  • Family Medicine
  • Accepts Insurance
  • CLIA Number: 24D2309672
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-19-2026

About ESSENTIA HEALTH ST. MARY'S - LAKE PARK CLINIC

This page provides the complete NPI Profile along with additional information for Essentia Health St. Mary's - Lake Park Clinic, a primary care provider established in Lake Park, Minnesota operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1548604309 assigned on April 2013. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Essentia Health St. Mary's - Lake Park Clinic operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Essentia Health St. Mary's - Lake Park Clinic. The authorized official of this NPI record is Alan Hurley (Coo)

NPI
1548604309
Provider Legal Name
ST. MARY'S REGIONAL HEALTH CENTER
Other Organization Name
ESSENTIA HEALTH ST. MARY'S - LAKE PARK CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1005 1ST ST LAKE PARK, MN 56554
Location Phone
(218) 238-5901
Mailing Address
1027 WASHINGTON AVE DETROIT LAKES, MN 56501
Mailing Phone
(218) 238-5901
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
04-24-2013
Last Update Date
03-01-2024
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A primary care provider (PCP) like Essentia Health St. Mary's - Lake Park Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

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

  • Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Bronze HSA - EPO
  • Essentia Choice Care with Medica Bronze Share - EPO
  • Essentia Choice Care with Medica Bronze Share - HMO
  • Essentia Choice Care with Medica Expanded Bronze Standard - EPO
  • Essentia Choice Care with Medica Expanded Bronze Standard - HMO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Gold Share - EPO
  • Essentia Choice Care with Medica Gold Share - HMO
  • Essentia Choice Care with Medica Gold Standard - EPO
  • Essentia Choice Care with Medica Gold Standard - HMO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Silver Share - EPO
  • Essentia Choice Care with Medica Silver Share - HMO
  • Essentia Choice Care with Medica Silver Standard - EPO
  • Essentia Choice Care with Medica Silver Standard - HMO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Medica Individual Choice Bronze Share - 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

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

ALAN HURLEY

Authorized Official Title
COO
Authorized Official Phone
(701) 364-7667

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
892442000MEDICAID (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
24D2309672
Facility Type
Physician Office
Certificate Effective Date
August 20, 2024
Certificate Expiration Date
August 19, 2026
Laboratory Director
AARON W. SYKES
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Essentia Health St. Mary's - Lake Park 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.

Reviews for ESSENTIA HEALTH ST. MARY'S - LAKE PARK CLINIC

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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 1548604309, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

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
5
Unchanged
Pos 3
4
Doubled → 8
Pos 4
8
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
0
Unchanged
Pos 7
4
Doubled → 8
Pos 8
3
Unchanged
Pos 9
0
Doubled → 0
Check
9
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 4 → 8 6 → 12 → 3 4 → 8 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 5 + 8 + 8 + 1 + 2 + 0 + 8 + 3 + 0 + 24 = 61

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

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1548604309.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548604309, enumerated as an "organization" on April 24, 2013.

The provider is located at 1005 1ST ST LAKE PARK, MN 56554 and the phone number is (218) 238-5901.

Family Medicine with taxonomy code 207Q00000X.

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