BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS (NPI# 1699701375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699701375 |
| Entity Type | Organization |
| Organization Name | BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS |
| Other Organization Name | BAD RIVER HEALTH AND WELLNESS CENTER |
| Practice Address |
53585 Nokomis Road Ashland WI 54806-4272 |
| Practice Telephone | 7156827133 |
| Practice Fax Number | 7156857857 |
| Mailing Telephone | 7156827133 |
| Mailing Fax Number | 7156857857 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2016-04-06 |
| Authorized Official Name | MRS. DEBRA ANN TUTOR (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 7156827133 |
| Is Organization Subpart | Y |
| Parent Organization Name | BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251K00000X | Public Health or Welfare | WI | Agencies | |
| N | 122300000X | Dentist | WI | Dental Providers | |
| N | 261Q00000X | Clinic/Center | WI | Ambulatory Health Care Facilities | |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | TRAILBLAZER/MEDICARE | TRZ020 | 01 |
| WI | 32957600 | 05 |
| Other Name | Type Code |
|---|---|
| Bad River Health and Wellness Center | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780702829 | Bad River Band of Lake Superior Tribe of Chippewa Indians Wis | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2007-03-27 |
| Street Address |
53585 NOKOMIS ROAD |
| City | ASHLAND |
| State | WI |
| Zip Code | 54806-4272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457301152 | Kristan A Wegerson | Family Medicine | 53585 Nokomis Road, Ashland, WI 54806 | 2006-05-11 |
| 1063781888 | Ila Anderson | Pharmacist | 53585 Nokomis Road, Ashland, WI 54806 | 2011-12-22 |
| 1598055816 | Pamela Jo Feustel | Registered Nurse | 53585 Nokomis Road, Ashland, WI 54806-4272 | 2011-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992236525 | Robin Jurgensen | Counselor | 1619 W Third Street, Ashland, WI 54806 | 2017-03-24 |
| 1922479195 | Alexa M Honstad | Registered Nurse | Memorial Medical Center, Inc, 1615 Maple Lane, Ashland, WI 54806 | 2015-10-14 |
| 1982032728 | Noel Hong | Pharmacist | 1800 Us Highway 2, Ashland, WI 54806 | 2013-10-14 |
| 1588909402 | Kelli Danielle Culver | Registered Nurse | 216 3rd St W Ste 201, Ashland, WI 54806 | 2012-12-04 |
| 1114191756 | Karen Keyes | Occupational Therapist | 1635 Maple Lane, Behavioral Health Services, Ashland, WI 54806 | 2008-04-15 |
| 1174645204 | Michael Allyn Turgeon | Social Worker | 517 Beaser Avenue, Ashland, WI 54806 | 2007-04-06 |
| 1770669269 | Laura Anton Ia Nitsche | Speech-Language Pathologist | 618 Beaser Avenue, Ashland, WI 54806 | 2006-10-27 |
| 1104915222 | Patrick Alan Hickman | Chiropractor | 400 East Lakeshore Drive, Ashland, WI 54806 | 2006-10-12 |
| 1386732113 | Janet Lee Sternat | Physical Therapist | 618 Beaser Ave, Cesa #12, Ashland, WI 54806 | 2006-10-10 |
| 1295743193 | Ashland Dental Clinic Inc | Dentist | 300 9th Ave W, Ashland, WI 54806 | 2006-08-04 |
| Find all providers in zip 54806 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376009407 | North Mississippi Primary Health Care, Inc. | Clinic/Center | 16025 Boundary Drive, Ashland, MS 38603 | 2019-02-13 |
| 1841742673 | The Lakes Community Health Center, Inc | Clinic/Center | 300 Main Street West, Ashland, WI 54806-3696 | 2016-10-27 |
| 1962833624 | Katahdin Valley Health Center | Clinic/Center | 33 Walker St, Ashland, ME 04732-3429 | 2013-12-06 |
| 1720215684 | The Lakes Community Health Center, Inc | Clinic/Center | 719 Main St East, Ashland, WI 54806-1918 | 2009-06-18 |
| 1205998309 | Rogue Community Health | Clinic/Center | 99 Central Avenue, Ashland, OR 97520-1787 | 2006-12-14 |
| 1104461805 | Third Street Community Clinic, Inc. | Clinic/Center | 309 Arthur St, Ashland, OH 44805-3206 | 2019-11-18 |
| 1144750266 | Katahdin Valley Health Center | Clinic/Center | 180 Presque Isle Rd, Ashland, ME 04732-3414 | 2017-06-13 |
| 1548711427 | Rogue Community Health | Clinic/Center | 364 Walker Ave, Ashland, OR 97520-2314 | 2016-10-17 |
| 1932575149 | Bighorn Valley Health Center, Incorporated | Clinic/Center | 501 Main Street, Ashland, MT 59003 | 2015-08-12 |
| 1902206857 | Lewis County Primary Care Center, Inc. | Clinic/Center | 432 16th St, Ashland, KY 41101-7693 | 2014-08-28 |
| Find all providers in ASHLAND | ||||
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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.