Town of Conover

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6011195 Issued in WI

Legal business name

TOWN OF CONOVER

Doing business as

Town of Conover Ambulance Service

Practice address

4665 County K E
Conover, WI 54519-0115

Phone

(715) 479-8688

Fax

(715) 479-8688

NPI assigned

Feb 8, 2010

Last updated

Feb 8, 2010By 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

Michael B Mergen, PARAMEDIC, BSBN

Title

GM

Phone

(320) 209-8125

Specialties & licenses 1

Addresses

Other names 1

• Town of Conover Ambulance Service 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": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1063744639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 627",
            "city": "ALBANY",
            "state": "MN",
            "postal_code": "563070627",
            "telephone_number": "320-209-8125",
            "fax_number": "877-715-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4665 COUNTY K E",
            "city": "CONOVER",
            "state": "WI",
            "postal_code": "545190115",
            "telephone_number": "715-479-8688",
            "fax_number": "715-479-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF CONOVER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "MERGEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "GM",
        "authorized_official_telephone_number": "320-209-8125",
        "authorized_official_credential": "PARAMEDIC, BSBN"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6011195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town of Conover Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathy Marie Holperin, O.T.
• Sadenwasser Behavioral Health & Wellness
• James Roswell Sherwood, LCSW
• Lori L Susdorf, RN
• Curtis John Welnetz, D.C.

• Land Ambulance in Conover, WI
• Providers in Conover, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; 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.