POTAWATOMI HEALTH & WELLNESS CENTER , NPI 1285741306
Clinic/Center in CRANDON, WI
Last Updated on : Dec 09,2020
About POTAWATOMI HEALTH & WELLNESS CENTER (NPI 1285741306)
POTAWATOMI HEALTH & WELLNESS CENTER (FOREST COUNTY POTAWATOMI COMMUNITY) is a Clinic/Center in CRANDON, United States with a focus in Federally Qualified Health Center (FQHC) .
1285741306 is NPI number of POTAWATOMI HEALTH & WELLNESS CENTER.
POTAWATOMI HEALTH & WELLNESS CENTER's primary taxonomy code based on NPI Lookup is 261QF0400X with license number . This taxonomy code refers to Clinic/Center.
POTAWATOMI HEALTH & WELLNESS CENTER current practice location address is 8201 MISH KO SWEN DRIVE, CRANDON, WI. POTAWATOMI HEALTH & WELLNESS CENTER can be reached out via phone at 715-478-4300 and via fax at 715-478-4300 .
You can also correspond with POTAWATOMI HEALTH & WELLNESS CENTER through mail at mailing address PO BOX 396, CRANDON, WI, United States. Mailing address contact number is 715-478-4300.
The enumeration date of POTAWATOMI HEALTH & WELLNESS CENTER is 24-Aug-2006. The provider is registered as an Organization and the NPI record was last updated 3 years ago. The authorized official of POTAWATOMI HEALTH & WELLNESS CENTER is NED DANIELS (Tribal Chairman). NED DANIELS can be reached at 7154784824.1285741306 NPI Information
Basic NPI information of POTAWATOMI HEALTH & WELLNESS CENTER (NPI 1285741306) is provided below.
| Name | POTAWATOMI HEALTH & WELLNESS CENTER |
|---|---|
| National Provider Id (NPI) | 1285741306 |
| Entity Type | Organization |
| Practice Address | 8201 MISH KO SWEN DRIVE,
CRANDON, WI, United States |
| Practice Telephone | 715-478-4300 |
| Practice Fax Number | 715-478-4300 |
| Mailing Address | PO BOX 396 ,
CRANDON, WI, United States |
| Mailing Telephone | 715-478-4300 |
| Mailing Fax Number | 715-478-4490 |
| Enumeration Date | 24-Aug-2006 |
| Last Updated Date | 09-Dec-2020 |
POTAWATOMI HEALTH & WELLNESS CENTER (NPI 1285741306) Primary Taxonomy Information
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs, the license data is associated to the taxonomy code.
| Primary | Taxonomy Code | Clasification | License Number | License State |
|---|---|---|---|---|
| Y | 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | WI |
POTAWATOMI HEALTH & WELLNESS CENTER (NPI 1285741306) Secondary Taxonomy Information
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs, the license data is associated to each taxonomy code.
| Primary | Taxonomy Code | Clasification | License Number | License State |
|---|---|---|---|---|
| N | 132700000X | Dietary Manager | ||
| N | 133N00000X | Nutritionist | ||
| N | 208000000X | Pediatrics | ||
| N | 261QC1500X | Clinic/Center, Community Health | ||
| N | 261QD0000X | Clinic/Center, Dental | ||
| N | 261QH0700X | Clinic/Center, Hearing and Speech | ||
| N | 261QP1100X | Clinic/Center, Podiatric | ||
| N | 261QR0200X | Clinic/Center, Radiology | ||
| N | 261QR0206X | Clinic/Center, Radiology, Mammography | ||
| N | 291U00000X | Clinical Medical Laboratory | ||
| N | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | ||
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | ||
| N | 332S00000X | Hearing Aid Equipment |
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type/Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 000023040 | MEDICARE PIN (08) | WI | |
| 32956600 | MEDICAID (05) | WI | |
| 391235059016 | Other (non-Medicare) (01) | WI | Blue Cross Blue Shield |
| 41752300 | Other (non-Medicare) (01) | WI | Durable Medical Equipment |
| 41752300 | MEDICAID (05) | WI | |
| 42182600 | Other (non-Medicare) (01) | WI | Mental Health |
| 42182600 | Other (non-Medicare) (01) | WI | AODA Clinic |
| 42182600 | MEDICAID (05) | WI | |
| 44006100 | Other (non-Medicare) (01) | WI | Prenatal Care |
| 44006100 | MEDICAID (05) | WI | |
| 5078550001 | MEDICARE NSC (07) | WI | |
| 521819 | MEDICARE OSCAR/Certification (06) | WI | |
| DA0385 | Other (non-Medicare) (01) | WI | Railroad Medicare |
POTAWATOMI HEALTH & WELLNESS CENTER (NPI 1285741306) Office Location
Office location of POTAWATOMI HEALTH & WELLNESS CENTER is provided in the Google maps below.Providers in same location
Here are a few of the other providers in the same location.
| NPI | Name | Taxonomy | Address | Enumeration date |
|---|---|---|---|---|
| 1609876655 | ARIZCONSIN GROUP INC | Skilled Nursing Facility | PO BOX 400,
CRANDON, WI, United States |
29-Jul-2005 |
| 1699068692 | ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. | Clinic/Center, Rural Health | 400 W GLEN ST,
CRANDON, WI, United States |
24-May-2011 |
| 1386267664 | ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. | 400 W GLEN ST,
CRANDON, WI, United States |
21-May-2020 | |
| 1578698916 | DIANE M BAIRD | Counselor, Professional | 3163 STATE HWY 55,
CRANDON, WI, United States |
23-Feb-2007 |
| 1689169492 | JAMIE DEAN BAUKNECHT | Licensed Practical Nurse | 3144 VANZILE RD,
CRANDON, WI, United States |
25-Jun-2018 |
| 1073613691 | WILLIAM DALE BECKER | Optometrist | 103 E WASHINGTON ST,
CRANDON, WI, United States |
24-Sep-2006 |
| 1861400731 | KAREN A BEIMBORN | Family Medicine | PO BOX 396,
5409 EVERYBODYS ROAD FOREST COUNTY POTAWATOMI HEALTH CRANDON, WI, United States |
04-Aug-2006 |
| 1366874489 | BOBBI JO KAPLA BISSONETTE | Nurse Practitioner, Family | 3144 VANZILE ROAD,
CRANDON, WI, United States |
31-Jul-2013 |
| 1518449487 | NICHOLAS BOLTE | Counselor, Addiction (Substance Use Disorder) | PO BOX 396,
CRANDON, WI, United States |
06-Sep-2018 |
| 1699436733 | AMY E BOOHER | Social Worker, Clinical | 8201 MISH KO SWEN DR,
CRANDON, WI, United States |
30-Dec-2021 |
| 1598954398 | RICHARD ARTHUR BRANDNER | Family Medicine | 3144 VANZILE RD,
CRANDON, WI, United States |
17-Oct-2007 |
| 1528348133 | LAURA JEAN CONNOR | Chiropractor | 505 W GLEN ST,
CRANDON, WI, United States |
26-Aug-2011 |
| 1285847145 | COUNTY OF FOREST | Public Health or Welfare | 200 E MADISON ST,
CRANDON, WI, United States |
08-May-2007 |
| 1205917366 | CRANDON AREA RESCUE SQUAD, INC | Ambulance | PO BOX 302,
CRANDON, WI, United States |
17-Oct-2006 |
| 1528138062 | CRANDON CHIROPRACTIC S.C. | Chiropractor | 409 N LAKE AVE,
CRANDON, WI, United States |
09-Nov-2006 |
| 1861590200 | CRANDON VISION CENTER | Optometrist | 103 E WASHINGTON ST,
CRANDON, WI, United States |
20-Sep-2006 |
| 1205911831 | KRISTIN MARY DAHMS | Physician Assistant | 400 W GLEN ST,
CRANDON, WI, United States |
25-Oct-2006 |
| 1972231959 | SHELBY LYNN DANIELS | Counselor, Addiction (Substance Use Disorder) | 8201 MISH KO SWEN DR,
CRANDON, WI, United States |
09-Aug-2022 |
| 1144621376 | DANIEL DASHNER | Counselor, Addiction (Substance Use Disorder) | 8201 MISH KO SWEN DR,
CRANDON, WI, United States |
08-Sep-2014 |
| 1598336620 | JOLENE A DERFUS | Counselor, Addiction (Substance Use Disorder) | 4851 HAM LAKE RD,
WABENO, WI, United States |
09-Jul-2021 |
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FAQs
Whose NPI Number is 1285741306?1285741306 is the NPI number of POTAWATOMI HEALTH & WELLNESS CENTER.
Where is POTAWATOMI HEALTH & WELLNESS CENTER located?POTAWATOMI HEALTH & WELLNESS CENTER is located at 8201 MISH KO SWEN DRIVE, CRANDON, WI.
NPI number meaning
| Field Name | Field Value |
|---|---|
| NPI | 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. |
| Entity Type | Code describing the type of health care provider that is being assigned an NPI.
Codes are:
|
| Provider Business Mailing Address | The mailing address of the provider being identified contains First line, Second Line, City name, State name, Postal code, and Country code. |
| Provider Business Mailing Address Telephone Number | The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number". |
| Provider Business Mailing Address Fax Number | The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''. |
| Provider Business Practice Location Address Telephone Number | The telephone number associated with the location address of the provider being identified. |
| Provider Business Practice Location Address Fax Number | The fax number associated with the location address of the provider being identified. |
| Provider Enumeration Date | The date the provider was assigned a unique identifier (assigned an NPI). |
| Last Update Date | The date that a record was last updated or changed. |
| Authorized Official Telephone Number | The 10-position telephone number of the authorized official. |
| Healthcare Provider Taxonomy Code | The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. |
| Healthcare Provider Taxonomy | Taxonomy Description of the Healthcare Provider. |
| Provider License Number | Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section. |
| Provider License Number State Code | Provider License Number State Code #1 |
| Healthcare Provider Primary Taxonomy Switch | Primary Taxonomy:
|