NPIMap

Organization Active NPI

St. Croix Tribal Council

  • Federally Qualified Health Center (FQHC)
  • Webster, WI
National Provider Identifier
1831170091
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ST. CROIX TRIBAL COUNCIL
Practice address
4404 State Road 70
Webster, WI 54893-9251
Phone
(715) 349-8554
Fax
(715) 349-8529
NPI assigned
Nov 7, 2005
Last updated
Oct 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Amber Heinz
Title
Health Director
Phone
(715) 349-8554

Specialties & licenses 1

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

Addresses

Primary practice location

4404 State Road 70
Webster, WI 54893-9251

Mailing address

4404 State Road 70
Webster, WI 54893-9251
Phone (715) 349-8554

Other names 2

  • St. Croix Chippewa Indians of Wisconsin Other name
  • St. Croix Tribal Health Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050419000754 WI Part B Supplier - Clinic/Group Practice 1153369350 Receives reassigned benefits from 13 practitioners
Practice locations: Webster, WI; Luck, WI
O20251003001301 WI Part A Provider - Federally Qualified Health Center (FQHC) 1153369350 Practice locations: Webster, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831170091. Details of each certification follow.

Federally qualified health center certification: CCN 521056

Legal name
ST. CROIX TRIBAL COUNCIL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 21, 2025
Last certification
Aug 21, 2025
Ownership / control type
For profit – corporation
Organization structure
OtherProprietary
Enrollment address
4404 State Road 70
Webster, WI 54893-9251

National Provider Directory

National Provider Directory
Tax ID family
St Croix Tribal Council7 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.

Locations

2221 60th St
Luck, WI 54853
Phone (715) 857-5694

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
St. Croix Tribal Council Organization, Webster, WI 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Amber Heinz Individual W-2 Managing EmployeeAd;MD; Jan 1, 2025

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1831170091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 STATE ROAD 70",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "548939251",
            "telephone_number": "715-349-8554",
            "fax_number": "715-349-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 STATE ROAD 70",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "548939251",
            "telephone_number": "715-349-8554",
            "fax_number": "715-349-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CROIX TRIBAL COUNCIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "HEINZ",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "715-349-8554"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Croix Chippewa Indians of Wisconsin",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "St. Croix Tribal Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Webster, WI

Sources for this page

Verify at the official NPI Registry.