STOCKBRIDGE MUNSEE COMMUNITY (NPI# 1942331467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942331467 |
| Entity Type | Organization |
| Organization Name | STOCKBRIDGE MUNSEE COMMUNITY |
| Other Organization Name | STOCKBRIDGE MUNSEE HEALTH & WELLNESS |
| Practice Address |
W12802 County Road A Bowler WI 54416-0086 |
| Practice Telephone | 7157934144 |
| Practice Fax Number | 7157934120 |
| Mailing Telephone | 7157934144 |
| Mailing Fax Number | 7157934120 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-12-04 |
| Authorized Official Name | ROBERT CHICKS (PRESIDENT) |
| Authorized Official Telephone | 7157934111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33021000 | 05 | |
| WI | NCPDC-PHARMACY | 5118799 | 01 |
| Other Name | Type Code |
|---|---|
| Stockbridge Munsee Health & Wellness | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629070180 | Stockbridge Munsee Community | Clinic/Center | W12802 Cty Rd A, Bowler, WI 54416 | 2005-08-15 |
| Street Address |
W12802 COUNTY ROAD A |
| City | BOWLER |
| State | WI |
| Zip Code | 54416-0086 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063512382 | Debra Anne Safford | Nurse Practitioner | W12802 County Road A, Bowler, WI 54416-9551 | 2006-09-25 |
| 1730788555 | Seth Evans | Pharmacy | W12802 County Road A, Bowler, WI 54416-9551 | 2020-10-22 |
| 1619455607 | Krystyna Diane Ostrowski | Nurse Practitioner | W12802 County Road A, Bowler, WI 54416-9551 | 2018-08-01 |
| 1053854885 | Casey Mitchell | Dietitian, Registered | W12802 County Road A, Bowler, WI 54416-9551 | 2016-11-28 |
| 1174976179 | Sheena Spencer | Dental Hygienist | W12802 County Road A, Bowler, WI 54416-9551 | 2016-07-14 |
| 1164821260 | Katie Kaczmarski | Pharmacist | W12802 County Road A, Bowler, WI 54416-9551 | 2014-08-14 |
| 1124359872 | Kristin A D'acquisto | Dental Hygienist | W12802 County Road A, Bowler, WI 54416-9551 | 2010-01-20 |
| 1033440953 | Mary Rose Murray | Dietitian, Registered | W12802 County Road A, Bowler, WI 54416-9551 | 2010-01-15 |
| 1033367685 | Toni L Montez | Dental Hygienist | W12802 County Road A, Bowler, WI 54416-9551 | 2008-09-08 |
| 1740438688 | Mary K Danner | Dental Hygienist | W12802 County Road A, Bowler, WI 54416-9551 | 2008-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730602442 | Jennifer Potts | Counselor | 6200 Excelsior Blvd Ste 204, St. Louis Park, MN 54416 | 2017-07-25 |
| 1285020701 | Donna L Powless | Counselor | W12802 Cty Hwy A, Bowler, WI 54416 | 2015-04-10 |
| 1174518385 | Thomas Paul Wargo | Chiropractor | W12802 County Highway A, Bowler, WI 54416 | 2005-09-14 |
| 1629070180 | Stockbridge Munsee Community | Clinic/Center | W12802 Cty Rd A, Bowler, WI 54416 | 2005-08-15 |
| 1720646433 | Jodie Colleen Skenandore | Counselor | W12802 County Highway A, Bowler, WI 54416 | 2019-05-29 |
| 1033677216 | Marlene B Miller | Counselor | W12802 County Highway A, Bowler, WI 54416 | 2019-03-07 |
| 1952891020 | Whitney Marie Schreiber | Registered Nurse | W12802 Cty Hwy A, Bowler, WI 54416 | 2018-05-15 |
| 1245686047 | Stockbridge Munsee Health and Wellness Center | Clinic/Center | W12802 Cty Hwy A, Bowler, WI 54416 | 2016-05-11 |
| 1013398387 | Paul Favela | Dentist | W12802 Cty Hwy A, Bowler, WI 54416 | 2015-06-12 |
| 1659767382 | Stockbridge-munsee Health and Wellness Center | Clinic/Center | W12802 County Highway A, Bowler, WI 54416 | 2015-04-09 |
| Find all providers in zip 54416 | ||||
| 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 |
| 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 |
| 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 |
Please comment or provide details below to improve the information on STOCKBRIDGE MUNSEE COMMUNITY.
| 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.