NPIMap

Organization Active NPI

Mille Lacs Band of Ojibwe Indians

Doing business as Ne-Ia-Shing Clinic

  • Federally Qualified Health Center (FQHC)
  • Onamia, MN
National Provider Identifier
1740357169
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MILLE LACS BAND OF OJIBWE INDIANS
Doing business as
Ne-Ia-Shing Clinic
Practice address
18562 Minobimaadizi Loop
Onamia, MN 56359
Phone
(888) 622-4163
NPI assigned
Nov 29, 2006
Last updated
Mar 17, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MILLE LACS BAND OF OJIBWE INDIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Nicole Anderson
Title
Commissioner of Health & Human Serv
Phone
(320) 532-4163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

18562 Minobimaadizi Loop
Onamia, MN 56359

Mailing address

18562 Minobimaadizi Loop
Onamia, MN 56359-3001
Phone (888) 622-4163

Other identifiers 1

IdentifierTypeStateIssuer
085753000MedicaidMN

Other names 1

  • Ne-Ia-Shing Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100902000134 MN Part A Provider - Federally Qualified Health Center (FQHC) 5991869471 Practice locations: Onamia, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740357169. Details of each certification follow.

Federally qualified health center certification: CCN 241819

Legal name
MILLE LACS BAND OF OJIBWE INDIANS
Doing business as
NE IA SHING CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 1, 1994
Last certification
Dec 1, 1994
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
18562 Minobimaadizi Loop
Onamia, MN 56359-3001

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mille Lacs Band of Ojibwe Indians16 organizations share this tax ID, including this one
Part of
Mille Lacs Band of Ojibwe Indians

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Janice D Manary Individual Corporate DirectorExecutive Dir. of Health Service Jan 28, 2019
Mille Lacs Band of Ojibwe Indians Organization, Onamia, MN Operational/Managerial Control Jun 30, 1978
Nicole Anderson Individual Corporate OfficerCommissioner of Health & Human S Feb 14, 2019
Corporate DirectorCommissioner of HHS Feb 14, 2019
Operational/Managerial ControlCommissioner of HHS Feb 14, 2019
Holly Hunter Individual Corporate Director Jan 1, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
East Lake ClinicMcGregor, MN, CCN 241858 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 1995
Aazhoomog ( Lake Lena) ClinicSandstone, MN, CCN 241859 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 May 21, 2013
Jan 16, 2009

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1740357169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18562 MINOBIMAADIZI LOOP",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563593001",
            "telephone_number": "888-622-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18562 MINOBIMAADIZI LOOP",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "56359",
            "telephone_number": "888-622-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLE LACS BAND OF OJIBWE INDIANS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLE LACS BAND OF OJIBWE INDIANS",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "COMMISSIONER OF HEALTH & HUMAN SERV",
        "authorized_official_telephone_number": "320-532-4163"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085753000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ne-Ia-Shing Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Onamia, MN

Sources for this page

Verify at the official NPI Registry.