Lac Du Flambeau Band of Lake Superior Chippewa Indians
Organization Active NPI Federally Qualified Health Center (FQHC) · Lac Du Flambeau, WI
NPI 1306016563 · NPPES record last updated Apr 22, 2026
Key facts
- NPI
- 1306016563
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
- Practice address
- 533 Peace Pipe Road
Lac Du Flambeau, WI 54538-0189 - Phone
- (715) 588-1511
- Fax
- (715) 588-3903
- NPI assigned
- Mar 4, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- LAC DU FLAMBEAU BAND OF LAKE SUPERIOR CHIPPEWA INDIANS
Authorized official
- Name
- Charmaine A Hopkins
- Title
- FRC Exec. Admin Asst.
- Phone
- (715) 588-1511
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 2
Practitioners 36
-
Jaci L Blaszak, OT
-
Kelly J Burg, LCSW,SAC
-
Ronald J Cooper, MD
-
Linda M Daniels, LCSW
-
Lucas C Daniels, NP
-
Kari A Dingman, OTR, CHT
-
Regina Rae Fox, LPC, CSAC
-
Briana Jean Hoban, LCSW
-
David C Larsen, DPM
-
Jacob Lindner, DC
-
Melissa Maki, DPT
-
Shannon S Meyer, DPM
-
Jill C Redman, O.D.
-
Linda Seale, MD
-
Suanne Vannatter, MHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050221000179 | WI | Part B Supplier - Clinic/Group Practice | 5496707242 |
Receives reassigned benefits from 19 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lac Du Flambeau, WI |
National Provider Directory
- Tax ID family
- Lac Du Flambeau Band of Lake Superior Chippewa Indians
- Part of
- Lac Du Flambeau Band of Lake Superior Chippewa Indians
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
533 Peace Pipe Road
Lac Du Flambeau, WI 54538-0189
Mailing address
533 Peace Pipe Rd
Lac Du Flambeau, WI 54538-9123
Phone (715) 588-1511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100368442 | Medicaid | WI | |
| 42145400 | Medicaid | WI | |
| 43084300 | Medicaid | WI |
Other names
- Family Resource Center
Other providers in Lac Du Flambeau, WI
- Linda Jean Kirkpatrick
- Kevin A Knudson
- Tresa Lynn Kronberger
- Scott C Kuehn
- Lac Du Flambeau Band of Lake Superior Chippewa Indians
- Lac Du Flambeau Band of Lake Superior Chippewa Indians
- Lac Du Flambeau Band of Lake Superior Chippewa Indians
- Lac Du Flambeau Band of Lake Superior Chippewa Indians
- Lac Du Flambeau Band of Lake Superior Chippewa Indians
- Lac Du Flambeau Public Schools
All providers in Lac Du Flambeau, WI · Federally Qualified Health Center (FQHC) in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.