SOKAOGON CHIPPEWA COMMUNITY NPI 1033115456

NPI Information

  • NPI: 1033115456
  • Provider Name: SOKAOGON CHIPPEWA COMMUNITY
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • CLIA Number: 52D0693164
  • Address: 3144 VANZILE RD
    CRANDON, WI
    ZIP 54520
  • Phone: (715) 478-5180

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NPI Details

SOKAOGON CHIPPEWA COMMUNITY is a federally qualified health center (fqhc) clinic center in Crandon, WI. SOKAOGON CHIPPEWA COMMUNITY NPI is 1033115456. The provider is registered as an organization entity type.

The provider's business location address is:

3144 VANZILE RD
CRANDON, WI
ZIP 54520-149
Phone: (715) 478-5180
Fax: (715) 478-5904

The provider's authorized official is Chris Mcgeshick .
The authorized official title is Clinic Director and has the following contact phone number (715) 478-5180.

The CLIA number assigned to this NPI record is 52D0693164 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/21/2005 and was last updated on 3/25/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)32957000WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
132957000MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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