NPIMap

Organization Active NPI

Polk County Health Dept

  • Public Health or Welfare Agency
  • Balsam Lake, WI
National Provider Identifier
1780800144
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
92 Issued in WI
Legal business name
POLK COUNTY HEALTH DEPT
Practice address
100 Polk County PLZ
Suite 180
Balsam Lake, WI 54810-9071
Phone
(715) 485-8500
Fax
(715) 485-8501
NPI assigned
Apr 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gretchen Sampson, RN, MPH
Title
Director
Phone
(715) 485-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 92 WI Primary

Addresses

Primary practice location

100 Polk County PLZ
Suite 180
Balsam Lake, WI 54810-9071

Mailing address

100 Polk County PLZ
Suite 180
Balsam Lake, WI 54810-9071
Phone (715) 485-8500

Other identifiers 1

IdentifierTypeStateIssuer
42008500MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Portage County Health7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780800144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 POLK COUNTY PLZ",
            "address_2": "SUITE 180",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548109071",
            "telephone_number": "715-485-8500",
            "fax_number": "715-485-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 POLK COUNTY PLZ",
            "address_2": "SUITE 180",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548109071",
            "telephone_number": "715-485-8500",
            "fax_number": "715-485-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY HEALTH DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-485-8500",
        "authorized_official_credential": "RN, MPH"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "WI",
            "license": "92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42008500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Balsam Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.