MENOMINEE TRIBAL CLINIC – NPI #1568404721
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

MENOMINEE TRIBAL CLINIC is a provider located in KESHENA, WI. NPPES has assigned the NPI number 1568404721 to MENOMINEE TRIBAL CLINIC on June 12, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MENOMINEE TRIBAL CLINIC” is a dba name, the actual legal business name for this organization is MENOMINEE INDIAN TRIBE OF WISCONSIN. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 7 years ago on Apr 02, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MENOMINEE TRIBAL CLINIC below.

NPI Profile for
MENOMINEE INDIAN TRIBE OF WISCONSIN

NPI Number
1568404721
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MENOMINEE INDIAN TRIBE OF WISCONSIN
Doing Business As (dba): MENOMINEE TRIBAL CLINIC
Primary location
W3275 WOLF RIVER ROAD
KESHENA, WI 54135
Phone: (715) 799-3361 Fax: (715) 799-3099
Mailing address
PO BOX 970
KESHENA, WI 54135-0970
Phone: (715) 799-3361 Fax: (715) 799-3099
Organization Subpart
No
Authorized Official
JERRY WAUKAU
HEALTH ADMINISTRATOR
Phone: (715) 799-3361
Updated
Identifiers

Identifiers for MENOMINEE TRIBAL CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDWI32955700
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.