NPIMap

Organization Active NPI

The Lakes Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Lakewood, WI
National Provider Identifier
1699778233
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
4757-800 Issued in WI
Legal business name
THE LAKES COMMUNITY HEALTH CENTER, INC
Practice address
15397 State Highway 32
Lakewood, WI 54138-9702
Phone
(715) 276-6321
Fax
(715) 276-1428
NPI assigned
May 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Authorized official

Name
Reba Rice
Title
Ceo
Phone
(715) 372-5001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 4757-800 WI Primary

Addresses

Primary practice location

15397 State Highway 32
Lakewood, WI 54138-9702

Mailing address

PO Box 179
Lakewood, WI 54138-0179
Phone (715) 276-6321

Other identifiers 1

IdentifierTypeStateIssuer
3295500MedicaidWI

Other names 1

  • The Lakes Community Health Center, Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101019000186 WI Part B Supplier - Clinic/Group Practice 0840366654 Receives reassigned benefits from 119 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White Lake, WI; Washburn, WI; Turtle Lake, WI; Solon Springs, WI; Eau Claire, WI; Rice Lake, WI; Poplar, WI; Park Falls, WI…

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory

Locations

207 W Lincoln St
Ste 1
Augusta, WI 54722
Phone (715) 286-2270

Practitioners & affiliated clinicians

Practitioners 75

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 75

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1699778233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "LAKEWOOD",
            "state": "WI",
            "postal_code": "541380179",
            "telephone_number": "715-276-6321",
            "fax_number": "715-276-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15397 STATE HIGHWAY 32",
            "city": "LAKEWOOD",
            "state": "WI",
            "postal_code": "541389702",
            "telephone_number": "715-276-6321",
            "fax_number": "715-276-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LAKES COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "REBA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "715-372-5001"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WI",
            "license": "4757-800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3295500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lakes Community Health Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.