Village of Pender

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1230 Issued in NE

Legal business name

VILLAGE OF PENDER

Doing business as

Pender Rescue

Practice address

314 Maple St
Pender, NE 68047

Phone

(402) 572-4019

Fax

(402) 965-8594

NPI assigned

Aug 16, 2006

Last updated

Apr 20, 2008By 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

Mr. Arden Shadbolt

Title

Chairman

Phone

(402) 572-4019

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PENDER RESCUE Doing business as

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacy Benne, RDH

  • Dental Hygienist
  • Thurston, NE
  • NPI 1891388138
  NPD

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1114030798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641880",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647880",
            "telephone_number": "402-572-4019",
            "fax_number": "402-965-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 MAPLE ST",
            "city": "PENDER",
            "state": "NE",
            "postal_code": "68047",
            "telephone_number": "402-572-4019",
            "fax_number": "402-965-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF PENDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SHADBOLT",
        "authorized_official_first_name": "ARDEN",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "402-572-4019",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NE",
            "license": "1230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "09447",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PENDER RESCUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Tiahrt, M.D.
• Leslie L Timm, BSN, RN
• Lillie Mae Timm
• Matthew J. Timm, MD
• Susan Urbanec
• Vogt Pharmacies Inc (The Apothecary Shop)
• Angela Marie Wegner
• Trisha Wegner, PLMHP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.