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NORTHLAKES COMMUNITY CLINIC
NPI 1083961163
Clinic/Center - Federally Qualified Health Center (FQHC) in Minong, WI

Active since August 08, 2012CLIA 52D0397081 · Certificate of Compliance
600 W SHELL CREEK RD, MINONG, WI 54859(715) 466-2201(715) 466-2205 Get Directions Write a Review

NPPES record last updated: August 5, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 5, 2021, Feb 5, 2019, Jan 28, 2019 (3 updates tracked since 2019).

About Northlakes Community Clinic NPPES

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

NORTHLAKES COMMUNITY CLINIC (NPI 1083961163) is a healthcare organization registered as a federally qualified health center (fqhc) in Minong, Wisconsin and active in the NPI registry since August 2012. The organization holds a CLIA Certificate of Compliance certificate valid through June 3, 2027 and lists Reba Rice, Ceo, as its authorized official.

NPPES Registry Identity

NPI1083961163
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameTHE LAKES COMMUNITY HEALTH CENTER, INC
Location Address600 W SHELL CREEK RDMinong, WI 54859-9302
Mailing Address15735 W Us Highway 63Hayward, WI 54843-6475 · (715) 934-0710 · Fax (715) 598-4881
Phone(715) 466-2201
Fax(715) 466-2205
Organization SubpartNo
Authorized OfficialReba RiceCeo · (715) 372-5001
Enumeration DateAugust 8, 2012
Last NPPES UpdateAugust 5, 20213 updates tracked since enumeration
NPPES CertifiedAugust 5, 2021
✔ NPI 1083961163 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
License✔ Licensed in WI · 26972
600 W SHELL CREEK RD, Minong, WI 54859
Open in Google Maps ↗

Other Names 1

Doing Business AsNorthlakes Community Clinic

Other Identifiers 1

Medicaid1811178825WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Quartz, Security Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 52D0397081

Northlakes Community Clinic · Minong, WI
Active · expires Jun 3, 2027
CLIA Number52D0397081
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJune 4, 2025
Certificate Expiration DateJune 3, 2027
Laboratory DirectorDr. Dodson W. Thompson
Laboratory Phone(715) 466-2201
Laboratory LocationNorthlakes Community Clinic600 Shell Creek Rd, Minong, WI 54859
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 4

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

PAUL DAVID WORKMAN
Counselor (Professional)
600 W SHELL CREEK RD
MINONG, WI 54859
Washburn County (715) 466-2201
THE LAKES COMMUNITY HEALTH CENTER, INC
Pharmacy (Clinic Pharmacy)
600 W SHELL CREEK RD
MINONG, WI 54859
Washburn County (715) 466-2201
MR. FREDERICK D KOSMACH PA-C
Physician Assistant
600 W SHELL CREEK RD
MINONG, WI 54859
Washburn County (715) 466-2201
HEATHER L RUNGE PA-C
Physician Assistant (Medical)
600 W SHELL CREEK RD
MINONG, WI 54859
Washburn County (715) 466-2201

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 The Lakes Community Health Center, Inc's NPI number?

The NPI number for The Lakes Community Health Center, Inc is 1083961163. It was assigned to this organization in the NPPES registry on August 8, 2012. The provider is doing business as Northlakes Community Clinic.

Where is The Lakes Community Health Center, Inc located?

The Lakes Community Health Center, Inc is located at 600 W Shell Creek Rd, Minong, WI 54859. The listed phone number is (715) 466-2201.

What is The Lakes Community Health Center, Inc's specialty?

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

Does The Lakes Community Health Center, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 52D0397081) is associated with this NPI, valid through June 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does The Lakes Community Health Center, Inc accept?

Health plans from HealthPartners, Quartz and Security Health Plan list The Lakes Community Health Center, Inc 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 The Lakes Community Health Center, Inc was last updated on August 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.