City of Ravenna

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

5107 Issued in NE

Legal business name

CITY OF RAVENNA

Doing business as

Ravenna Emergency Unit

Practice address

224 Alba Ave
Ravenna, NE 68869-1304

Phone

(877) 218-4392

Fax

(877) 343-0131

NPI assigned

Apr 5, 2006

Last updated

Aug 14, 2023By 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

Mrs. Peggy Dethlefs

Title

Captain

Phone

(308) 379-3107

Specialties & licenses 1

Addresses

Other names 1

• RAVENNA EMERGENCY UNIT Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1083676860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 FARNAM DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543237",
            "telephone_number": "531-895-5853",
            "fax_number": "877-343-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 ALBA AVE",
            "city": "RAVENNA",
            "state": "NE",
            "postal_code": "688691304",
            "telephone_number": "877-218-4392",
            "fax_number": "877-343-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF RAVENNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "DETHLEFS",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "CAPTAIN",
        "authorized_official_telephone_number": "308-379-3107",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NE",
            "license": "5107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAVENNA EMERGENCY UNIT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RAVENNA EMERGENCY UNIT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Anderson, SLP
• Ashley Denni Barry, LMT
• McKenzie Elyse Hoehn Bohling
• Hilary Bolling
• Mary Jo Busch
• Michelle E. Clark, APRN
• Pamela Sue Dethlefs
• Family Physical Therapy & Sports Center
• Karalee Fiddelke, REGISTERED NURSE
• Misti D Fiddelke, MPT

• Land Ambulance in Ravenna, NE
• Providers in Ravenna, NE by specialty
• Land Ambulance in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.