City of Washburn

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

41323800 Issued in WI

Legal business name

CITY OF WASHBURN

Doing business as

Washburn Area Ambulance

Practice address

119 Washington Ave.
Washburn, WI 54891

Phone

(715) 373-6160

NPI assigned

Feb 2, 2007

Last updated

Oct 26, 2011By 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

Tammy L. Demars

Title

Administrative Assistant

Phone

(715) 373-6160

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Washburn Area Ambulance Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1063550820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WASHINGTON AVE.",
            "address_2": "P.O BOX 638",
            "city": "WASHBURN",
            "state": "WI",
            "postal_code": "54891",
            "telephone_number": "715-373-6160",
            "fax_number": "715-373-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WASHINGTON AVE.",
            "city": "WASHBURN",
            "state": "WI",
            "postal_code": "54891",
            "telephone_number": "715-373-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF WASHBURN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "DEMARS",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "715-373-6160"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medical Technician, Basic",
            "state": "WI",
            "license": "41323800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41323800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washburn Area Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Basic Emergency Medical Technician in Washburn, WI
• Providers in Washburn, WI by specialty
• Basic Emergency Medical Technician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.