The Lakes Community Health Center, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Eau Claire, WI
NPI 1891452314 · NPPES record last updated Jun 10, 2025
Key facts
- NPI
- 1891452314
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- THE LAKES COMMUNITY HEALTH CENTER, INC
- Practice address
- 2119 Heights Dr
Eau Claire, WI 54701-6130 - Phone
- (715) 861-7901
- Fax
- (715) 861-7905
- NPI assigned
- Nov 18, 2021
- Organization subpart
- No
Authorized official
- Name
- Ana Tochterman
- Title
- Ceo
- Phone
- (888) 834-4551
Other NPIs on the same Medicare enrollment 17
Other NPIs with the same Medicare PAC ID 12
Corporate family (same tax ID) 19
Practitioners 104
-
Naomi Lyn Adams, LCSW
-
Sean Akerman, LPC
-
Allison Allen, PH.D.
-
Jodi Ann Bergstrom, O.D.
-
John Berlin, FNP
-
Katelyn Boney, APNP
-
Alexis Bowe, MSW
-
Benjamin Britain, LPC
-
Laurie Ann Buesing, LPC-IT
-
Melissa Carpenter, MS, LPC
-
Emma R Cole, APRN, CNP
-
Megan Collins, LPC
-
Ellyn Conhartoski, LPC-IT
-
Deborah A Dryer-Akl, M.D.
-
Caitlin A Dufour, LCSW, SAC-IT
-
Christi Fowler, MS, NCC, LPC
-
Shelly A Gallenberg, PH.D.
-
Mark Gideonsen, MD
-
Nina J Gilberg, M.D.
-
Brenda K Goettl, CSW, CADC III
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI
Federally qualified health center certification: CCN 521038
- Legal name
- THE LAKES COMMUNITY HEALTH CENTER INC
- Doing business as
- NORTHLAKES COMMUNITY CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 29, 2024
- Last certification
- Mar 29, 2024
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 14, 2007 in WI
- Enrollment address
- 2119 Heights Dr
Eau Claire, WI 54701-6130
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Ana Tochterman |
Corporate Officer |
Jan 1, 2025 | |
| Lisa Kingfisher |
Corporate Director |
Jan 1, 2022 | |
| Amy Klebe |
Corporate Director |
Jan 1, 2022 | |
| Jason Martell |
Corporate Director |
Jan 1, 2022 | |
| Joann Fleming |
Corporate Director |
Jan 1, 2022 | |
| Rebecca S Rice |
W-2 Managing Employee |
Mar 5, 2009 | |
| Nikolai Eliot |
Corporate Director |
Jan 1, 2022 | |
| John B Schrock |
Corporate Director |
Jan 1, 2022 | |
| Nancy Miller |
Corporate Director |
Jan 1, 2022 | |
| David Krochalk |
Corporate Director |
Jan 1, 2022 | |
| Michael Flaherty |
Corporate Director |
Jan 1, 2022 | |
| Michael Stamp |
Corporate Director |
Jan 1, 2022 | |
| Mary Jo Becker |
Corporate Director |
Jan 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101019000186 | WI | Part B Supplier - Clinic/Group Practice | 0840366654 |
Receives reassigned benefits from 119 practitioners 17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: White Lake, WI; Washburn, WI; Turtle Lake, WI; Solon Springs, WI; Eau Claire, WI; Rice Lake, WI; Poplar, WI; Park Falls, WI… |
| O20240425000706 | WI | Part a Provider - Federally Qualified Health Center (FQHC) | 0840366654 | Practice locations: Eau Claire, WI |
National Provider Directory
- Tax ID family
- The Lakes Community Health Center Inc
Locations
2119 Heights Dr
Eau Claire, WI 54701
Phone (715) 717-5899
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
2119 Heights Dr
Eau Claire, WI 54701-6130
Mailing address
15735 W US Highway 63
Hayward, WI 54843-6475
Phone (715) 934-0710
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811178825 | Medicaid | WI |
Other names
- NorthLakes Community Clinic
Other providers in Eau Claire, WI
- Cathleen Tessmer
- Thiyagarajan Thangavelu
- Duree Driscoll Thatcher
- The Arc Eau Claire
- The Lakes Community Health Center, Inc
- The Winkley Company
- The Young Men'S Christian Association of Eau Claire Wisconsin
- Isaac Theerman
- Angela M Theisen
- Joseph Raymond Theisen
All providers in Eau Claire, WI · Federally Qualified Health Center (FQHC) in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.