BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS (NPI# 1780702829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780702829 |
| Entity Type | Organization |
| Organization Name | BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS WIS |
| Other Organization Name | BAD RIVER CLINIC PHARMACY |
| Practice Address |
53585 Nokomis Rd Ashland WI 54806-4272 |
| Practice Telephone | 7156828518 |
| Practice Fax Number | 7156827753 |
| Mailing Telephone | 7156828518 |
| Mailing Fax Number | 7156827753 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2018-02-28 |
| Authorized Official Name | MR. MICHAEL WIGGINS JR. (TRIBAL CHAIRMAN) |
| Authorized Official Telephone | 7156827111 |
| Is Organization Subpart | Y |
| Parent Organization Name | BAD RIVER BAND OF LAKE SUPERIOR CHIPPEWA INDANS WIS. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Bad River Clinic Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699701375 | Bad River Band of Lake Superior Tribe of Chippewa Indians Wis | Public Health or Welfare | 53585 Nokomis Road, Ashland, WI 54806-4272 | 2006-06-24 |
| Street Address |
53585 NOKOMIS RD |
| City | ASHLAND |
| State | WI |
| Zip Code | 54806-4272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841290616 | Sharon Handy | Family Medicine | 53585 Nokomis Rd, Attn: Sharon Handy Md, Ashland, WI 54806-4272 | 2005-07-22 |
| 1790386670 | Tina Marie Gerovac-lavasseur | Registered Nurse | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2020-11-05 |
| 1508476052 | Tammie S Jonas-marsland | Nurse Practitioner | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2020-08-08 |
| 1063046431 | Russell John Denomie | Counselor | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2020-02-25 |
| 1578121208 | Jennifer Ann Sorel | Counselor | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2019-05-29 |
| 1437649373 | Jeanne Lorette Waters | Social Worker | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2018-05-16 |
| 1437649399 | Jacquelyn Christine Brown | Registered Nurse | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2018-05-16 |
| 1588154405 | Lisa Marie Gilles | Registered Nurse | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2018-05-16 |
| 1750807913 | Deann Lynette Carlson | Dental Hygienist | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2017-08-19 |
| 1588115018 | Bad River Band of Lake Superior Tribe of Chippewa Indians | Registered Nurse | 53585 Nokomis Rd, Ashland, WI 54806-4272 | 2016-10-19 |
| Find all providers in the same location | ||||
| 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 | 332800000X |
| Grouping | Suppliers |
| Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487875787 | St. Croix Tribal Council | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 4404 State Rd 70, Webster, WI 54893 | 2007-05-02 |
| 1487812897 | Ho-chunk Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | S2845 White Eagle Rd, Baraboo, WI 53913-9064 | 2008-06-02 |
| 1386802718 | Ho-chunk Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | N6520 Lumberjack Guy Rd, Black River Falls, WI 54615-5405 | 2008-06-02 |
| 1942331467 | Stockbridge Munsee Community | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | W12802 County Road A, Bowler, WI 54416-0086 | 2007-03-08 |
| 1447271408 | Lac Du Flambeau Band of Lake Superior Chippewa Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 129 Old Abe Rd, Lac Du Flambeau, WI 54538 | 2006-07-22 |
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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.