NPIMap

Organization Active NPI

Gerald L. Ignace Indian Health Center, Inc.

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1275707010
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
GERALD L. IGNACE INDIAN HEALTH CENTER, INC.
Practice address
930 W Historic Mitchell St
Milwaukee, WI 53204-3533
Phone
(414) 383-9526
Fax
(414) 649-2711
NPI assigned
Apr 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Dr. Lyle Anthony Ignace, MD
Title
Ceo
Phone
(414) 383-9526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

930 W Historic Mitchell St
Milwaukee, WI 53204-3533

Mailing address

930 W Historic Mitchell St
Milwaukee, WI 53204-3533
Phone (414) 383-9526

Other identifiers 1

IdentifierTypeStateIssuer
100066093MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Lac Courte Oreilles Governing8 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.

Locations

13380 W Trepania Rd
Hayward, WI 54843
Phone (715) 638-5100

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1275707010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 W HISTORIC MITCHELL ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043533",
            "telephone_number": "414-383-9526",
            "fax_number": "414-649-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 W HISTORIC MITCHELL ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043533",
            "telephone_number": "414-383-9526",
            "fax_number": "414-649-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD L. IGNACE INDIAN HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "IGNACE",
        "authorized_official_first_name": "LYLE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-383-9526",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100066093",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.