Individual provider Active NPI

Nikisha Blue Waters Lapine, MSW

  • Clinical Social Worker
  • Iron Mountain, MI
National Provider Identifier
1710517883
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801106247 Issued in MI
Practice address
440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone
(906) 776-9040
Fax
(906) 774-7279
NPI assigned
Jan 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801106247 MI Primary
Mental Health Counselor 101YM0800X 6801117454 MI

Addresses

Primary practice location

440 Woodward Ave
Iron Mountain, MI 49801-4631

Mailing address

744 S Webster Ave
Medical Staff Services
Green Bay, WI 54301-3505

Other practice location 1

106 S School Rd
Daggett, MI 49821-8555
Phone (906) 753-2155

Other names 1

  • Nikisha Blue Waters Zanon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402001871 MI Practitioner - Clinical Social Worker 8325486939 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801106247MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center, Inc. CurrentSince Feb 28, 2024 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 19, 2025 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Feb 28, 2024 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center, Inc. Current Accepting new patients
Bellin Psychiatric Center Inc. Current Accepting new patients
Bellin Psychiatric Center Inc. Mental Health CurrentSince Feb 28, 2024 Accepting new patients

Locations

106 S School Rd
Daggett, MI 49821
Phone (906) 753-2155

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

1100 10th St
Menominee, MI 49858
Phone (906) 863-2256

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

Interoperability endpoints

  • Direct secure messaging: nzanon924884@direct.emplifyhealth.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1710517883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WOODWARD AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014631",
            "telephone_number": "906-776-9040",
            "fax_number": "906-774-7279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 S School Rd",
            "address_purpose": "LOCATION",
            "city": "Daggett",
            "state": "MI",
            "postal_code": "498218555",
            "country_code": "US",
            "telephone_number": "906-753-2155",
            "fax_number": "906-753-2716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAPINE",
        "first_name": "NIKISHA",
        "middle_name": "BLUE WATERS",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106247",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801117454",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKISHA",
            "last_name": "ZANON",
            "middle_name": "BLUE WATERS",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.