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CENTRAL LAKES MEDICAL CLINIC PA
NPI 1881621761
Family Medicine in Crosby, MN

Active since June 27, 2006
318 EAST MAIN STREET, CROSBY, MN 56441(218) 546-8375(218) 546-4400 Get Directions Write a Review

NPPES record last updated: October 9, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Central Lakes Medical Clinic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTRAL LAKES MEDICAL CLINIC PA (NPI 1881621761) is a healthcare organization registered as a family medicine in Crosby, Minnesota and active in the NPI registry since June 2006. The organization lists John D Peterson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1881621761
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCENTRAL LAKES MEDICAL CLINIC PA
Location Address318 EAST MAIN STREETCrosby, MN 56441-1691
Mailing Address318 East Main StreetCrosby, MN 56441-1691 · (218) 546-8375 · Fax (218) 546-4400
Phone(218) 546-8375
Fax(218) 546-4400
Organization SubpartNo
Authorized OfficialJohn D PetersonCeo · (218) 546-2501
Enumeration DateJune 27, 2006
Last NPPES UpdateOctober 9, 2008
✔ NPI 1881621761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MN · 1160
Definition
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.
318 EAST MAIN STREET, Crosby, MN 56441
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Other Identifiers 3

Medicaid088208900MN
Medicare NSC0603250001MN
Medicare PIN08289MN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANE MARIE PALKERT MD
Orthopaedic Surgery
318 EAST MAIN STREET, CENTRAL LAKES MEDICAL CLINIC PA
CROSBY, MN 56441
Crow Wing County (218) 546-8375
DR. PEGGY A RUTMAN MD
Family Medicine
318 EAST MAIN STREET, CENTERAL LAKES MEDICAL CLINIC, P.A.
CROSBY, MN 56441
Crow Wing County (218) 546-8375
DONNA CLAYPOOL N.P.
Nurse Practitioner (Obstetrics & Gynecology)
318 EAST MAIN STREET
CROSBY, MN 56441
Crow Wing County (218) 546-8375

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Central Lakes Medical Clinic PA's NPI number?

The NPI number for Central Lakes Medical Clinic PA is 1881621761. It was assigned to this organization in the NPPES registry on June 27, 2006.

Where is Central Lakes Medical Clinic PA located?

Central Lakes Medical Clinic PA is located at 318 East Main Street, Crosby, MN 56441. The listed phone number is (218) 546-8375.

What is Central Lakes Medical Clinic PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Central Lakes Medical Clinic PA was last updated on October 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.