Organization Active NPI

La Pointe Community Clinic Inc

  • Family Medicine Physician
  • La Pointe, WI
National Provider Identifier
1003079740
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LA POINTE COMMUNITY CLINIC INC
Practice address
241 Big Bay Road
La Pointe, WI 54850
Phone
(715) 747-2722
NPI assigned
Jul 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Margie A Frederickson, MDNPI 1336195536
Title
Clinic Manager
Phone
(715) 747-2722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

241 Big Bay Road
La Pointe, WI 54850

Mailing address

241 Big Bay Road
PO Box 45
La Pointe, WI 54850
Phone (715) 747-2722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121012000640 WI Part B Supplier - Clinic/Group Practice 4789745860 Receives reassigned benefits from 4 practitioners
Practice locations: La Pointe, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1060116La Pointe Community Clinic Inc241 Big Bay Rd, La Pointe, WI 54850Provider-performed microscopyMay 2, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1003079740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 BIG BAY ROAD",
            "address_2": "PO BOX 45",
            "city": "LA POINTE",
            "state": "WI",
            "postal_code": "54850",
            "telephone_number": "715-747-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 BIG BAY ROAD",
            "city": "LA POINTE",
            "state": "WI",
            "postal_code": "54850",
            "telephone_number": "715-747-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA POINTE COMMUNITY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "FREDERICKSON",
        "authorized_official_first_name": "MARGIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "715-747-2722",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Pointe, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.