| Lac Courte Oreilles Community Health Center | |
|
13380 W Trepania Rd Hayward WI 54843-2186 | |
| (715) 638-5100 | |
| (715) 634-6107 |
| Full Name | Lac Courte Oreilles Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 13380 W Trepania Rd, Hayward, Wisconsin |
| Authorized Official Name and Position | Rae E Baker (BILLING COORDINATOR) |
| Authorized Official Contact | 7156385169 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lac Courte Oreilles Community Health Center 13380 W Trepania Rd Hayward WI 54843-2186 Ph: (715) 638-5100 | Lac Courte Oreilles Community Health Center 13380 W Trepania Rd Hayward WI 54843-2186 Ph: (715) 638-5100 |
| NPI Number | 1194830208 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 10/04/2023 |
| Medicare PECOS PAC ID | 7810983517 |
|---|---|
| Medicare Enrollment ID | O20040420001318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194830208 | NPI | - | NPPES |
| 32956000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | David C Larsen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1235125204 PECOS PAC ID: 1254237472 Enrollment ID: I20031209000802 |
| Provider Name | Shannon S Meyer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316933542 PECOS PAC ID: 4486550613 Enrollment ID: I20031209000837 |
| Provider Name | Guillermo E Gonzalez |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023114246 PECOS PAC ID: 4183691660 Enrollment ID: I20040914000697 |
| Provider Name | Adrienne D Laverdure |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639119225 PECOS PAC ID: 1850280876 Enrollment ID: I20051025000720 |
| Provider Name | Modesto M Ferrer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134164403 PECOS PAC ID: 5092728634 Enrollment ID: I20060726000103 |
| Provider Name | Jerilou A Wiedmeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376736140 PECOS PAC ID: 7416040530 Enrollment ID: I20070906000204 |
| Provider Name | Mahmoud A Sharaf |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356677447 PECOS PAC ID: 1254479371 Enrollment ID: I20091111000070 |
| Provider Name | Harry D Malcolm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144251166 PECOS PAC ID: 7517093727 Enrollment ID: I20100326000762 |
| Provider Name | Jessica Hartmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578656591 PECOS PAC ID: 3173704616 Enrollment ID: I20110216001077 |
| Provider Name | Lester Yan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497862387 PECOS PAC ID: 9537331434 Enrollment ID: I20111019000762 |
| Provider Name | Amanda L Suino-malcolm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356684880 PECOS PAC ID: 2769616655 Enrollment ID: I20131008001681 |
| Provider Name | Roger A Handtke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396776589 PECOS PAC ID: 4284767419 Enrollment ID: I20150115002072 |
| Provider Name | Steven Craig Miszkiewicz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548257249 PECOS PAC ID: 1456343128 Enrollment ID: I20170215001536 |
| Provider Name | Anthony L Mannila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053851204 PECOS PAC ID: 0143506758 Enrollment ID: I20170414000293 |
| Provider Name | Angela Pank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730721150 PECOS PAC ID: 6709139538 Enrollment ID: I20191108001221 |
| Provider Name | Danielle Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265052146 PECOS PAC ID: 2163846148 Enrollment ID: I20200723001130 |
| Provider Name | Tina M Stec |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1568670586 PECOS PAC ID: 2668725672 Enrollment ID: I20200922001928 |
| Provider Name | Charles M Hausman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1497060099 PECOS PAC ID: 4082890009 Enrollment ID: I20210128001353 |
| Provider Name | William M Winselman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790409589 PECOS PAC ID: 7618337452 Enrollment ID: I20230815003685 |
| Provider Name | Michelle L Lowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346939410 PECOS PAC ID: 1658725866 Enrollment ID: I20230921002289 |
Ashland Audiology Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11040 N State Road 77, Hayward, WI 54843 Phone: 715-682-9311 Fax: 715-682-9313 | |
Northlakes Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11128 N State Road 77, Hayward, WI 54843 Phone: 715-634-2541 Fax: 715-634-5740 | |
Northwoods Chiropractic Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15614 Windrose Ln, Suite 300, Hayward, WI 54843 Phone: 715-634-9911 Fax: 715-634-9911 | |
Clinic Services Of Hayward Area Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11040 N State Road 77, Hayward, WI 54843 Phone: 715-934-4245 | |
Essentia Health Hayward Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11134 N State Road 77, Hayward, WI 54843 Phone: 715-634-5505 | |
Lac Courte Oreilles Community Health Cente Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13394 W Trepania Rd, Lac Courte Oreilles Governing Board, Hayward, WI 54843 Phone: 715-634-5100 Fax: 715-634-6107 |