NPIMap

Organization Active NPI

Red Cliff Band of Lake Superior Chippewa

  • Durable Medical Equipment & Medical Supplies
  • Bayfield, WI
National Provider Identifier
1083885545
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
4179800 Issued in WI
Legal business name
RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA
Practice address
88455 Pike Road
Bayfield, WI 54814
Phone
(715) 779-3707
Fax
(715) 779-3711
NPI assigned
Mar 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Ms. Patricia Ann Deragon-Navarro
Title
Health Administrator
Phone
(715) 779-3707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 4179800 WI Primary

Addresses

Primary practice location

88455 Pike Road
Bayfield, WI 54814

Mailing address

88385 Pike Rd
Bayfield, WI 54814-4818
Phone (715) 779-3700

Other identifiers 1

IdentifierTypeStateIssuer
41759800OtherWIMEDICAID-DMS

Other names 1

  • Red Cliff Community Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Red Cliff Trib Amb Ser9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73851

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1083885545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88385 PIKE RD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144818",
            "telephone_number": "715-779-3700",
            "fax_number": "715-779-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88455 PIKE ROAD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "54814",
            "telephone_number": "715-779-3707",
            "fax_number": "715-779-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "DERAGON-NAVARRO",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "715-779-3707",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "4179800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-DMS",
            "identifier": "41759800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Cliff Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.