NPIMap

Organization Active NPI

Bad River Health Clinic

  • Clinic/Center
  • Odanah, WI
National Provider Identifier
1013093285
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BAD RIVER HEALTH CLINIC
Practice address
1 Maple Street
Odanah, WI 54861
Phone
(715) 682-7133
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary Bigboy
Title
Clinic Manager
Phone
(715) 682-7133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1 Maple Street
Odanah, WI 54861

Mailing address

N87W16462 Jacobson Dr
Menomonee Falls, WI 53051-2833
Phone (262) 255-1040

National Provider Directory

National Provider Directory
Tax ID family
Bad River Band of Lake Superior Tribe of Chippewa Indains Wis8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013093285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N87W16462 JACOBSON DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512833",
            "telephone_number": "262-255-1040",
            "fax_number": "262-255-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAPLE STREET",
            "city": "ODANAH",
            "state": "WI",
            "postal_code": "54861",
            "telephone_number": "715-682-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAD RIVER HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BIGBOY",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "715-682-7133"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odanah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.