MENOMINEE TRIBAL CLINIC-WOMEN'S PERSONAL HEALTH
NPI 1164618088
Clinic/Center - Family Planning, Non-Surgical in Keshena, WI
- Organization
- Clinic/Center
- Family Planning, Non-Surgical
- CLIA Number: 52D0394456
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 01-12-2027
About MENOMINEE TRIBAL CLINIC-WOMEN'S PERSONAL HEALTH
This page provides the complete NPI Profile along with additional information for Menominee Tribal Clinic-women's Personal Health, a provider established in Keshena, Wisconsin operating as a Clinic/center, focusing in family planning, non-surgical . The healthcare provider is registered in the NPI registry with number 1164618088 assigned on September 2007. The practitioner's primary taxonomy code is 261QF0050X with license number 93107-030 (WI). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Menominee Tribal Clinic-women's Personal Health. The authorized official of this NPI record is Jerry L Waukau Sr. (Health Administrator)
- NPI
- 1164618088 Verify this NPI
- Provider Legal Name
- MENOMINEE INDIAN TRIBE OF WISCONSIN
- Other Organization Name
- MENOMINEE TRIBAL CLINIC-WOMEN'S PERSONAL HEALTH
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- W3275 WOLF RIVER ROAD KESHENA, WI 54135
- Location Phone
- (715) 799-3361
- Location Fax
- (715) 799-3099
- Mailing Address
- PO BOX 970 KESHENA, WI 54135
- Mailing Phone
- (715) 799-3361
- Mailing Fax
- (715) 799-3099
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-25-2007
- Last Update Date
- 03-11-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Family Planning, Non-Surgical
- Taxonomy Code
- 261QF0050X
- Type
- Ambulatory Health Care Facilities
- License No.
- 93107-030
- License State
- WI
- Taxonomy Description
- An entity, facility, or distinct part of a facility, or mobile unit providing non-surgical, family planning/reproductive services including physical examination, laboratory services such as PAP or pregnancy tests; pregnancy, pregnancy prevention/contraceptive, and nutritional counseling, and contraceptives or prescriptions for contraceptives.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 42010500 | MEDICAID (05) | WI | |
| 000036030 | MEDICARE PIN (08) | WI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D0394456
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- January 13, 2025
- Certificate Expiration Date
- January 12, 2027
- Laboratory Director
- DR. AMY J. SLAGLE
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Menominee Tribal Clinic-women's Personal Health on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
KESHENA, WI 54135
KESHENA, WI 54135
KESHENA, WI 54135
KESHENA, WI 54135
KESHENA, WI 54135
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164618088, enumerated as an "organization" on September 25, 2007.
The provider is located at W3275 WOLF RIVER ROAD KESHENA, WI 54135 and the phone number is (715) 799-3361.
Clinic/Center with taxonomy code 261QF0050X and a focus in Family Planning, Non-Surgical.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
