NPIMap

Organization Active NPI

Bad River Health and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Ashland, WI
National Provider Identifier
1255682183
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BAD RIVER HEALTH AND WELLNESS CENTER
Practice address
53585 Nokomis Rd
Ashland, WI 54806-4272
Phone
(715) 682-7133
Fax
(715) 685-7857
NPI assigned
Oct 2, 2012
Last updated
Oct 2, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
BAD RIVER BAND OF LAKE SUPERIOR CHIPPEWA INDIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Authorized official

Name
Mrs. Debra Ann Tutor
Title
Clinic Administrator
Phone
(715) 682-7133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

53585 Nokomis Rd
Ashland, WI 54806-4272

Mailing address

53585 Nokomis Rd
Ashland, WI 54806-4272
Phone (715) 682-7133

Other names 1

  • Bad River Dental Office Other name

National Provider Directory

National Provider Directory
Tax ID family
Bad River CL-Pharmacy8 organizations share this tax ID, including this one
Part of
Bad River CL-Pharmacy

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": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1255682183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53585 NOKOMIS RD",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548064272",
            "telephone_number": "715-682-7133",
            "fax_number": "715-685-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53585 NOKOMIS RD",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548064272",
            "telephone_number": "715-682-7133",
            "fax_number": "715-685-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAD RIVER HEALTH AND WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAD RIVER BAND OF LAKE SUPERIOR CHIPPEWA INDIANS",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "TUTOR",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "715-682-7133",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bad River Dental Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ashland, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.