City of South Milwaukee

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6000171 Issued in WI

Legal business name

CITY OF SOUTH MILWAUKEE

Practice address

2424 15TH Ave
South Milwaukee, WI 53172-2410

Phone

(414) 762-2222

Fax

(414) 762-3272

NPI assigned

Oct 13, 2006

Last updated

Aug 24, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shannon Hrdlicka

Title

Administrative Assistant

Phone

(414) 768-8191

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• City of South Milwaukee

  dba South Milwaukee Health Department

  • State or Local Public Health Clinic/Center
  • South Milwaukee, WI
  • NPI 1871795690

  3375517238

  Same PAC ID

Tax ID family

City of South Milwaukee2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• City of South Milwaukee

  dba South Milwaukee Health Department

  • State or Local Public Health Clinic/Center
  • South Milwaukee, WI
  • NPI 1871795690
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• City of South Milwaukee

  dba South Milwaukee Health Department

  • State or Local Public Health Clinic/Center
  • South Milwaukee, WI
  • NPI 1871795690
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1053401018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 15TH AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722410",
            "telephone_number": "414-762-2222",
            "fax_number": "414-762-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 15TH AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722410",
            "telephone_number": "414-762-2222",
            "fax_number": "414-762-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SOUTH MILWAUKEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "HRDLICKA",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "414-768-8191"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6000171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Camillo, OTR
• Center for Self
• Tou Chang
• George D. Cherayil, M.D.
• Kayla Khanh Chu
• City of South Milwaukee (South Milwaukee Health Department)
• Megan Mae Clement, PHARMD
• Cheron Copeland, NDTR
• Dana Correnti, PA-C
• Michael L Costello, DDS

• Land Ambulance in South Milwaukee, WI
• Providers in South Milwaukee, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.