FOREST COUNTY POTAWATOMI HEALTH & WELLNESS CENTER
NPI 1376650499
Clinic/Center - Mental Health (Including Community Mental Health Center) in Crandon, WI
NPI Status: Active since August 24, 2006
Contact Information
8201 MISH KO SWEN DR
CRANDON, WI
ZIP 54520
Phone: (715) 478-4300
Fax: (715) 478-4490
- Organization
- Clinic/Center
- Mental Health (Including Community Menta...
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 52D0678081
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 05-17-2028
About FOREST COUNTY POTAWATOMI HEALTH & WELLNESS CENTER
This page provides the complete NPI Profile along with additional information for Forest County Potawatomi Health & Wellness Center, a provider established in Crandon, Wisconsin operating as a Clinic/center, focusing in mental health (including community mental health center) . The healthcare provider is registered in the NPI registry with number 1376650499 assigned on August 2006. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Forest County Potawatomi Health & Wellness Center operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mr. Ned Daniels (Tribal Chairman)
- NPI
- 1376650499
- Provider Name
- FOREST COUNTY POTAWATOMI HEALTH & WELLNESS CENTER
- Entity Type
- Organization
- Location Address
- 8201 MISH KO SWEN DR CRANDON, WI 54520
- Location Phone
- (715) 478-4300
- Location Fax
- (715) 478-4490
- Mailing Address
- PO BOX 396 8201 MISH KO SWEN DRIVE CRANDON, WI 54520
- Mailing Phone
- (715) 478-4300
- Mailing Fax
- (715) 478-4490
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-24-2006
- Last Update Date
- 12-09-2020
- Code Navigator
Forest County Potawatomi Health & Wellness Center is a medicare supplier with PTAN 20627519 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Canes and/or Crutches or Orthoses: Prefabricated (Non-Custom Fabricated) or Orthoses: Off-The-Shelf or Urological Supplies or Nebulizer Equipment and/or Supplies or Oxygen Equipment and/or Supplies or Surgical Dressings.
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 Mental Health (Including Community Mental Health Center)
- Taxonomy Code
- 261QM0801X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | |
| 3 | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Oak $1,300 Gold - PPO
- Oak $2,000 Standard Gold - PPO
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 |
|---|---|---|---|
| 42182600 | MEDICAID (05) | WI |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20627519
- Accepts Medicare Assignment
- YES
- Provider Type List
- INDIAN HEALTH SERVICE, PHYSICIAN – PODIATRY.
- Competitive Bidding
- NO
Supplies List
- Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
- Orthoses: Prefabricated (Non-Custom Fabricated) - Met pads, Heel pads, Heel spur pads
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Urological Supplies - Catheters, Urinary collection devices
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
- Oxygen Equipment and/or Supplies - Portable oxygen systems, Oxygen concentrators, Oxygen contents
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
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
- 52D0678081
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- May 18, 2026
- Certificate Expiration Date
- May 17, 2028
- Laboratory Director
- MS. SHER MCGREGOR
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Forest County Potawatomi Health & Wellness Center 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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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1376650499, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
CRANDON, WI 54520
CRANDON, WI 54520
CRANDON, WI 54520
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376650499, enumerated as an "organization" on August 24, 2006.
The provider is located at 8201 MISH KO SWEN DR CRANDON, WI 54520 and the phone number is (715) 478-4300.
Clinic/Center with taxonomy code 261QM0801X and a focus in Mental Health (Including Community Mental Health Center).
The provider might be accepting Accepts: HealthPartners, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
