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LAKE SUPERIOR COMMUNITY HEALTH CENTER
NPI 1063789022
Clinic/Center - Federally Qualified Health Center (FQHC) in Superior, WI

Active since November 18, 2011
2222 E 5TH ST, SUPERIOR, WI 54880(715) 392-1955(715) 392-1935 Get Directions Write a Review

NPPES record last updated: February 13, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 10, 2023, Feb 3, 2022, Oct 15, 2021 and 3 more (6 updates tracked since 2020).

About Lake Superior Community Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE SUPERIOR COMMUNITY HEALTH CENTER (NPI 1063789022) is a healthcare organization registered as a federally qualified health center (fqhc) in Superior, Wisconsin and active in the NPI registry since November 2011. The organization lists Lee Homan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1063789022
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameLAKE SUPERIOR COMMUNITY HEALTH CENTER
Location Address2222 E 5TH STSuperior, WI 54880-3709
Mailing Address2222 E 5th StSuperior, WI 54880-3709 · (715) 392-1955 · Fax (715) 392-1935
Phone(715) 392-1955
Fax(715) 392-1935
Organization SubpartNo
Authorized OfficialLee HomanCeo · (715) 392-1955
Enumeration DateNovember 18, 2011
Last NPPES UpdateFebruary 13, 20246 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2024
✔ NPI 1063789022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
2222 E 5TH ST, Superior, WI 54880
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Medica and more.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PENNY JO WALDUM RN
Registered Nurse
2222 E 5TH ST
SUPERIOR, WI 54880
Douglas County (715) 392-1955
HOLLY WOODHULL RN
Registered Nurse
2222 E 5TH ST
SUPERIOR, WI 54880
Douglas County (715) 392-1955
BLAIRE MARIE HYSJULIEN LCSW
Social Worker (Clinical)
2222 E 5TH ST
SUPERIOR, WI 54880
Douglas County (715) 395-5393
DR. MITCHELL LEE TSCHAKERT DDS
Dentist (General Practice)
2222 E 5TH ST
SUPERIOR, WI 54880
Douglas County (715) 394-5411
JACQUELYN K. LINDBERG LPC
Counselor (Professional)
2222 E 5TH ST
SUPERIOR, WI 54880
Douglas County (715) 392-1955
TIFFANY JOHNSON C-SAC
Counselor (Addiction (Substance Use Disorder))
2222 E 5TH ST
SUPERIOR, WI 54880
Douglas County (715) 392-1955
MS. CRYSTAL M NORRIS SAC-IT
Case Manager/Care Coordinator
2222 E 5TH ST
SUPERIOR, WI 54880
Douglas County (715) 392-1955
MRS. LAUREN ZAKOWITZ LPC-IT
Counselor (Professional)
2222 E 5TH ST
SUPERIOR, WI 54880
Douglas County (715) 392-1955

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Superior Community Health Center's NPI number?

The NPI number for Lake Superior Community Health Center is 1063789022. It was assigned to this organization in the NPPES registry on November 18, 2011.

Where is Lake Superior Community Health Center located?

Lake Superior Community Health Center is located at 2222 E 5th St, Superior, WI 54880. The listed phone number is (715) 392-1955.

What is Lake Superior Community Health Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

What insurance does Lake Superior Community Health Center accept?

Health plans from Anthem Blue Cross and Blue Shield, HealthPartners, Medica and Security Health Plan list Lake Superior Community Health Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Superior Community Health Center was last updated on February 13, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.