NPIMap

Organization Active NPI

County of Menominee

  • Community/Behavioral Health Agency
  • Keshena, WI
National Provider Identifier
1700931300
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
2228 Issued in WI
Legal business name
COUNTY OF MENOMINEE
Doing business as
Menominee County Human Services
Practice address
W3272 Wolf River Dr
Keshena, WI 54135-9202
Phone
(715) 799-3861
Fax
(715) 799-5317
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Authorized official

Name
Mrs. Shannon Wilber
Title
Executive Director
Phone
(715) 799-3861

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 2228 WI Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

W3272 Wolf River Dr
Keshena, WI 54135-9202

Mailing address

PO Box 280
Keshena, WI 54135-0280
Phone (715) 799-3861

Other names 1

  • Menominee County Human Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040604000476 WI Part B Supplier - Clinic/Group Practice 7214919000 Receives reassigned benefits from 1 practitioner
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Keshena, WI

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Menominee Co Human SRV8 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.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1700931300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541350280",
            "telephone_number": "715-799-3861",
            "fax_number": "715-799-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3272 WOLF RIVER DR",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541359202",
            "telephone_number": "715-799-3861",
            "fax_number": "715-799-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MENOMINEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "WILBER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "715-799-3861",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "2228",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Menominee County Human Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keshena, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.