Sokaogon Chippewa Community | |
3144 Vanzile Rd Crandon WI 54520-8149 | |
(715) 478-5180 | |
(715) 478-5904 |
Full Name | Sokaogon Chippewa Community |
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Speciality | Clinic/Center |
Location | 3144 Vanzile Rd, Crandon, Wisconsin |
Authorized Official Name and Position | Leah Newton (BILLING MANAGER) |
Authorized Official Contact | 7156220293 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sokaogon Chippewa Community 3144 Vanzile Rd Crandon WI 54520-8149 Ph: (715) 478-5180 | Sokaogon Chippewa Community 3144 Vanzile Rd Crandon WI 54520-8149 Ph: (715) 478-5180 |
NPI Number | 1033115456 |
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Provider Enumeration Date | 06/21/2005 |
Last Update Date | 09/01/2022 |
Medicare PECOS PAC ID | 1759370869 |
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Medicare Enrollment ID | O20040512000238 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033115456 | NPI | - | NPPES |
32957000 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 32957000 (Wisconsin) | Primary |
Provider Name | Shannon S Meyer |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1316933542 PECOS PAC ID: 4486550613 Enrollment ID: I20031209000837 |
Provider Name | Gary M Pusateri |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1851383525 PECOS PAC ID: 2668408071 Enrollment ID: I20050715000938 |
Provider Name | Eunice Corujo Incha |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1255371837 PECOS PAC ID: 9931125994 Enrollment ID: I20051019000215 |
Provider Name | Sylvia J Dennison |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1700838836 PECOS PAC ID: 6709897937 Enrollment ID: I20060531000211 |
Provider Name | Allen Craig Orth |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1073548517 PECOS PAC ID: 3870597545 Enrollment ID: I20060912000158 |
Provider Name | Suzette L Katchko |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073773677 PECOS PAC ID: 4880758721 Enrollment ID: I20090121000668 |
Provider Name | Stephanie Coons |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1467733576 PECOS PAC ID: 0042460313 Enrollment ID: I20121022000728 |
Provider Name | Bobbi Jo K Bissonette |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366874489 PECOS PAC ID: 1355575184 Enrollment ID: I20131010001708 |
Provider Name | Steven Craig Miszkiewicz |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1548257249 PECOS PAC ID: 1456343128 Enrollment ID: I20170215001536 |
Provider Name | Melinda Roth |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154757045 PECOS PAC ID: 5698900231 Enrollment ID: I20170920002093 |
Provider Name | Abigail B Ashbeck |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1437827441 PECOS PAC ID: 4789048943 Enrollment ID: I20230907000493 |
Provider Name | Lynette M Mccorkle |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1609115682 PECOS PAC ID: 7416305727 Enrollment ID: I20240228002465 |
Aspirus Crandon Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 W Glen St, Crandon, WI 54520 Phone: 715-478-3318 | |
Northwoods Behavioral Health Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 W Broad St, Crandon, WI 54520 Phone: 920-217-7910 | |
The Center For Human Restoration, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 505 W Glen St Ste 1, Crandon, WI 54520 Phone: 715-478-5202 Fax: 715-478-5205 |