Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

Lac Du Flambeau Band of Lake Superior Chippewa Indians

Federally Qualified Health Center (FQHC) in Lac Du Flambeau, WI · enumerated 2006 · authorized official Randy Samuelson, Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1134235047

Verified

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Registry record

Entity type Organization (Type 2)

Legal business name Lac Du Flambeau Band of Lake Superior Chippewa Indians

Other name <Unavail>

Parent organization Lac Du Flambeau Band of Lake Superior Chippewa Indians

Practice address 129 Old Abe Rd, Lac Du Flambeau, WI, 54538

Phone (715) 588-3371

Fax (715) 588-2031

Enumeration date Aug 22, 2006

Last updated in NPPES Sep 3, 2013

Taxonomy & classification

251B00000X Case Management Agency Agencies Secondary

261QF0400X Federally Qualified Health Center (FQHC) Ambulatory Health Care Facilities Primary

261QH0100X Health Service Clinic/Center Ambulatory Health Care Facilities Secondary

261QP2300X Primary Care Clinic/Center Ambulatory Health Care Facilities Secondary

Authorized official

Name Randy Samuelson

Title Administrator

Phone (715) 588-3371

Other identifiers

Identifier	Type	State	Issuer
32956800	Medicaid	WI	-
41854400	Medicaid	WI	-
44004700	Medicaid	WI	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2013-09-03. Verify at npiregistry.cms.hhs.gov.

Where is Lac Du Flambeau Band of Lake Superior Chippewa Indians located?

The practice location on file with NPPES is in Lac Du Flambeau, WI.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-09-03.