SAULT TRIBE OF CHIPPEWA INDIANS (NPI# 1477605137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477605137 |
| Entity Type | Organization |
| Organization Name | SAULT TRIBE OF CHIPPEWA INDIANS |
| Other Organization Name | KINROSS COMMUNITY CLINIC |
| Practice Address |
16877 S Water Tower Dr Kincheloe MI 49788-1507 |
| Practice Telephone | 9064955745 |
| Practice Fax Number | 9064955940 |
| Mailing Telephone | 9064955745 |
| Mailing Fax Number | 9064955940 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-10 |
| Authorized Official Name | BONNIE CULFA (HEALTH DIRECTOR) |
| Authorized Official Telephone | 9066325200 |
| Authorized Official Credential | RN,MSN |
| Is Organization Subpart | Y |
| Parent Organization Name | SAULT TRIBE OF CHIPPEWA INDIANS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
231881 | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FQHC FACILITY NUMBER | 231881 | 01 |
| Other Name | Type Code |
|---|---|
| Kinross Community Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922200203 | Sault Tribe of Chippewa Indians | Clinic/Center | 3355 N 3 Mile Road, Hessel, MI 49745 | 2007-05-31 |
| 1366643694 | Sault Tribe of Chippewa Indians | Clinic/Center | 4935 Zee Ba Tik Ln, Newberry, MI 49868-8188 | 2007-05-31 |
| 1588717839 | Sault Tribe of Chippewa Indians | Clinic/Center | 5698w Hwy Us2, Manistique, MI 49854 | 2007-01-19 |
| 1861545337 | Sault Tribe of Chippewa Indians | Clinic/Center | 346 Superior St, De Tour Village, MI 49725 | 2007-01-19 |
| 1891847067 | Sault Tribe of Chippewa Indians | Clinic/Center | 225 Wa Seh St, Saint Ignace, MI 49781-9490 | 2007-01-17 |
| 1508957747 | Sault Tribe of Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 5698 W Hwy Us 2, Manistique, MI 49854 | 2006-09-27 |
| 1922305416 | Sault Tribe of Chippewa Indians | Audiologist | 2864 Ashmun St, Sault Sainte Marie, MI 49783-3740 | 2011-02-17 |
| 1245534890 | Sault Tribe of Chippewa Indians | Social Worker | 1140 N State St, Suite 2805, Saint Ignace, MI 49781-1013 | 2010-12-22 |
| 1598999310 | Sault Tribe of Chippewa Indians | Social Worker | 2864 Ashmun St, Sault Sainte Marie, MI 49783-3740 | 2009-05-07 |
| 1477721058 | Sault Tribe of Chippewa Indians | Family Medicine | 2864 Ashmun St, Sault Sainte Marie, MI 49783-3740 | 2008-02-15 |
| Street Address |
16877 S WATER TOWER DR |
| City | KINCHELOE |
| State | MI |
| Zip Code | 49788-1507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164558524 | Thomas Christian Lehman | Dentist | 302 Watertower Drive, Kincheloe, MI 49788 | 2007-02-27 |
| 1760557391 | Kinross Charter Township | Ambulance | 4884 W. Curtis Street, Kincheloe, MI 49788 | 2006-11-21 |
| 1679718845 | Melba Jean Lofdahl | Foster Care Agency | 9 Kincheloe, Kincheloe, MI 49788-1220 | 2008-12-02 |
| 1174624134 | James E Adamo | Dentist | 16829 S Water Tower Dr, Unit 5, Kincheloe, MI 49788-1500 | 2006-09-25 |
| 1851434419 | Chippewa County War Memorial Hospital Inc | Family Medicine | 16523 S Water Tower Dr, Kincheloe, MI 49788-1592 | 2007-02-14 |
| 1609252980 | Katie Peabody | Recreation Therapist | 16523 S Water Tower Dr, Kincheloe, MI 49788-1592 | 2015-08-10 |
| 1013397942 | Lorenell Tomkinson | Social Worker | 16523 S Water Tower Dr, Kincheloe, MI 49788-1592 | 2015-06-05 |
| 1306249610 | Rafael Parsons Aguirre | Social Worker | 16523 S Water Tower Dr, Kincheloe, MI 49788-1592 | 2014-09-30 |
| 1982010864 | Jonathan Sommers | Nurse Practitioner | 16523 S Water Tower Dr, Kincheloe, MI 49788-1592 | 2014-07-11 |
| 1629260203 | Chippewa County War Memorial Hospital, Inc. | Psychiatric Unit | 16523 S Water Tower Dr, Kincheloe, MI 49788-1592 | 2007-08-16 |
| Find all providers in zip 49788 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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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.