FOREST COUNTY POTAWATOMI COMMUNITY (NPI# 1285741306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285741306 |
| Entity Type | Organization |
| Organization Name | FOREST COUNTY POTAWATOMI COMMUNITY |
| Other Organization Name | POTAWATOMI HEALTH & WELLNESS CENTER |
| Practice Address |
8201 Mish Ko Swen Drive Crandon WI 54520-8631 |
| Mailing Address |
Po Box 396 Crandon WI 54520-0396 |
| Practice Telephone | 7154784300 |
| Practice Fax Number | 7154784300 |
| Mailing Telephone | 7154784300 |
| Mailing Fax Number | 7154784490 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2017-08-25 |
| Authorized Official Name | MR. HAROLD FRANK (TRIBAL CHAIRMAN) |
| Authorized Official Telephone | 7154784360 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 132700000X | Dietary Manager | Dietary & Nutritional Service Providers | ||
| N | 133N00000X | Nutritionist | Dietary & Nutritional Service Providers | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
| N | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
Ambulatory Health Care Facilities | ||
| N | 261QP1100X |
Clinic/Center Specialization: Podiatric |
Ambulatory Health Care Facilities | ||
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| N | 261QR0206X |
Clinic/Center Specialization: Radiology, Mammography |
Ambulatory Health Care Facilities | ||
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| N | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| N | 332S00000X | Hearing Aid Equipment | Suppliers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32956600 | 05 | |
| WI | AODA CLINIC | 42182600 | 01 |
| WI | RAILROAD MEDICARE | DA0385 | 01 |
| WI | BLUE CROSS BLUE SHIELD | 391235059016 | 01 |
| WI | MENTAL HEALTH | 42182600 | 01 |
| WI | 44006100 | 05 | |
| WI | 41752300 | 05 | |
| WI | 42182600 | 05 | |
| WI | DURABLE MEDICAL EQUIPMENT | 41752300 | 01 |
| WI | PRENATAL CARE | 44006100 | 01 |
| Other Name | Type Code |
|---|---|
| POTAWATOMI HEALTH & WELLNESS CENTER | Doing Business As Name - Organization |
| Street Address |
8201 MISH KO SWEN DRIVE |
| City | CRANDON |
| State | WI |
| Zip Code | 54520-8631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902221989 | Anna E Lopez | Massage Therapist | 8201 Mish Ko Swen Drive, Crandon, WI 54520 | 2014-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255574364 | Anne Morris Warren | Counselor | 5409 Everybody's Rd, Crandon, WI 54520 | 2009-04-20 |
| 1568643922 | Karen Mihalko | Hearing Instrument Specialist | 106 W Madison Street, Crandon, WI 54520 | 2007-11-14 |
| 1558379438 | David R Kaufman Jr. | Pharmacist | 5409 Everybodys Rd, Forest County Potwatomi Health & Wellness Center, Crandon, WI 54520 | 2006-08-04 |
| 1114935095 | William R Pierre | Optometrist | 5409 Everbodys Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 | 2006-08-04 |
| 1285642165 | Christopher P Skaggs | Speech-Language Pathologist | 5409 Everybodys Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 | 2006-08-04 |
| 1720033186 | Frank Mraz | Family Medicine | 5409 Everybody's Road, Crandon, WI 54520 | 2006-05-24 |
| 1770978173 | Lana Winter | Counselor | 3144 Vanzile Rd, Crandon, WI 54520 | 2015-04-02 |
| 1992959654 | Lisa M Miller | Dietitian, Registered | 5409 Everybodys Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 | 2008-11-07 |
| 1902814882 | Kirk R Ritchie | Dentist | 5409 Everybodys Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 | 2006-08-04 |
| 1881602761 | Betty S Thunder | Social Worker | 5409 Everybody's Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 | 2006-08-04 |
| Find all providers in zip 54520 | ||||
| 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 |
|---|---|---|---|---|
| 1326693847 | Scenic Bluffs Health Center, Inc | Clinic/Center | 100 Blackhawk Dr, Viroqua, WI 54665-1315 | 2019-08-02 |
| 1942718762 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 2607 S 5th St, Milwaukee, WI 53207-1418 | 2018-01-15 |
| 1659884716 | The Lakes Community Health Center, Inc | Clinic/Center | 15954 Rivers Edge Dr Ste 304, Hayward, WI 54843-7800 | 2017-11-13 |
| 1275056632 | Outreach Community Health Centers, Inc. | Clinic/Center | 9120 W Hampton Ave Ste 119, Milwaukee, WI 53225-4960 | 2017-07-18 |
| 1437695038 | Scenic Bluffs Health Center, Inc. | Clinic/Center | 200 West North Street, Norwalk, WI 54648 | 2017-01-06 |
| 1841742673 | The Lakes Community Health Center, Inc | Clinic/Center | 300 Main Street West, Ashland, WI 54806-3696 | 2016-10-27 |
| 1174071658 | Kenosha Community Health Center, Inc. | Clinic/Center | 2310 Center St, Racine, WI 53403-3330 | 2016-09-14 |
| 1841652021 | Scenic Bluffs Health Center, Inc. | Clinic/Center | 201 E Franklin St Rm B3, Sparta, WI 54656-1803 | 2016-03-25 |
| 1366844003 | Scenic Bluffs Health Center, Inc | Clinic/Center | 201 E Franklin St # B3, Sparta, WI 54656-1803 | 2014-09-25 |
| 1679983423 | The Lakes Community Health Center, Inc | Clinic/Center | 524 Bissell Street, White Lake, WI 54491 | 2014-05-02 |
| Find all providers with the same taxonomy | ||||
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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.