Active NPI
La Pointe Community Clinic Inc
- Family Medicine Physician
- La Pointe, WI
National Provider Identifier
1003079740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Margie A Frederickson, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D1060116 | La Pointe Community Clinic Inc | Provider-performed microscopy | May 2, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- La Pointe, WI
- NPI 1336195536
Family Medicine, WI
-
- Family Nurse Practitioner
- Ashland, WI
- NPI 1568882736
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.