OrganizationActive
Bloomington Lake Clinic, Ltd
NPI 1215090501 · Multi-Specialty Clinic/Center · Bloomington, MN
Provider details
- NPI number
- 1215090501
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Debra Barger, Assistant Administrator(612) 277-2165
- License
- 23 (MN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7901 Xerxes Ave S Ste 116
Bloomington, MN 55431-1200
Phone: (952) 888-2024
Fax: (952) 888-3985
Street-level locationGet directions
Mailing address
7901 Xerxes Ave S Ste 116
Bloomington, MN 55431-1200
Registry dates
- Enumerated
- 2006-12-18
- Last updated
- 2011-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.