LAKE SUPERIOR COMMUNITY HEALTH CENTER
NPI 1639684384
Clinic/Center - Federally Qualified Health Center (FQHC) in Superior, WI

Q: 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.

Active since December 04, 2017

1500 N 34TH ST STE 200, SUPERIOR, WI 54880(715) 395-5380(715) 394-2682 Get Directions Write a Review

NPPES record last updated: February 8, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 8, 2021, Nov 4, 2020, Sep 11, 2020 and 1 more (4 updates tracked since 2017).

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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 1639684384) is a healthcare organization registered as a federally qualified health center (fqhc) in Superior, Wisconsin and active in the NPI registry since December 2017. The organization lists Jessie Peterson, Coo, as its authorized official.

NPPES Registry Identity

NPI1639684384

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameLAKE SUPERIOR COMMUNITY HEALTH CENTER

Location Address1500 N 34TH ST STE 200Superior, WI 54880-4477

Mailing Address1500 N 34th StSuperior, WI 54880-4477 · (715) 395-5380 · Fax (715) 394-2682

Phone(715) 395-5380

Fax(715) 394-2682

Organization SubpartNo

Authorized OfficialJessie PetersonCoo · (218) 722-1497

Enumeration DateDecember 4, 2017

Last NPPES UpdateFebruary 8, 20214 updates tracked since enumeration

NPPES CertifiedFebruary 8, 2021

✔ NPI 1639684384 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

1500 N 34TH ST STE 200, Superior, WI 54880

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Other Names 1

Doing Business AsLake Superior Community Health Center

Other Providers at the Same Location NPPES 3

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

NATALIE SELL

Case Manager/Care Coordinator

1500 N 34TH ST STE 200
SUPERIOR, WI 54880

Douglas County (715) 392-8216

NICHOLAS J KUVAAS

Case Manager/Care Coordinator

1500 N 34TH ST STE 200
SUPERIOR, WI 54880

Douglas County (715) 392-8216

PAIGE M KONRAD LMFT, LPC

Counselor (Professional)

1500 N 34TH ST STE 200
SUPERIOR, WI 54880

Douglas County (715) 395-5380

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 1639684384. It was assigned to this organization in the NPPES registry on December 4, 2017.

Where is Lake Superior Community Health Center located?

Lake Superior Community Health Center is located at 1500 N 34th St Ste 200, Superior, WI 54880. The listed phone number is (715) 395-5380.

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.

When was this NPI record last updated?

The NPPES record for Lake Superior Community Health Center was last updated on February 8, 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.